FDA Adverse Event
Malfunction
Summary report: N
KNIFE
MDR report key: 2201577
·
Received August 4, 2011
Report
- Report Number
- 2523835-2011-00129
- Event Type
- Malfunction
- Date Received
- August 4, 2011
- Date of Event
- June 20, 2011
- Report Date
- July 5, 2011
- Manufacturer
- ALCON PRECISION DEVICE - SINKING SPRING
- Product Code
- HNN
- PMA / PMN Number
- NA
- Removal / Correction Number
- NA
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- JA
- Reporter Occupation
- OTHER
Narratives
Additional Manufacturer Narrative · 1
A SAMPLE IS EXPECTED TO RETURN FOR IN-HOUSE EVALUATION. THE DEVICE HISTORY RECORD (DHR) FOR THE LOT WAS REVIEWED. FUNCTIONAL PENETRATION TEST VALUES FOR THE LOT MET SPECIFICATION. NO ABNORMALITIES THAT COULD HAVE CONTRIBUTED TO A DULL KNIFE WERE FOUND DURING THE DHR REVIEW AND THE PRODUCT WAS RELEASED ACCORDING TO MANUFACTURER'S ACCEPTANCE CRITERIA. THE ROOT CAUSE IS UNK AT THIS TIME. (B)(4).
Description of Event or Problem · 1
A CUSTOMER REPORTED POOR CUTTING PERFORMANCE DURING A PROCEDURE. THERE WAS NO PT HARM REPORTED. ADDITIONAL INFO HAS BEEN REQUESTED.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1 | KNIFE | MANUAL OPHTHALMIC SURGICAL INSTRUMENT | HNN | ALCON PRECISION DEVICE - SINKING SPRING | 8065912001 | 836929M |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 |