BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    ALLEGRETTO WAVE EYE-Q

    MDR report key: 2160957 · Received June 16, 2011

    Report

    Report Number
    3003288808-2011-00167
    Event Type
    Malfunction
    Date Received
    June 16, 2011
    Date of Event
    November 23, 2009
    Report Date
    November 23, 2009
    Manufacturer
    WAVELIGHT GMBH
    Product Code
    LZS
    PMA / PMN Number
    P030008
    Removal / Correction Number
    NA
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    CH
    Reporter Occupation
    UNKNOWN

    Narratives

    Additional Manufacturer Narrative · 1

    DURING THE ONSITE INVESTIGATION, THE SERVICE TECH REPLACED THE MONITOR. ROOT CAUSE WAS DETERMINED TO BE A FAULTY MONITOR. (B)(4).

    Description of Event or Problem · 1

    CUSTOMER REPORTS THE MONITOR HAS NO IMAGE. NO PT HARM WAS REPORTED AND NO ADDITIONAL INFO WAS PROVIDED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 ALLEGRETTO WAVE EYE-Q OPHTHALMIC EXCIMER LASER SYSTEM LZS WAVELIGHT GMBH 8065990631 NA

    Patients

    Seq Age Sex Outcome Treatment
    1