FDA Adverse Event Malfunction Summary report: N

ACCURUS 800CS

MDR report key: 2201626 · Received August 4, 2011

Report

Report Number
2028159-2011-00901
Event Type
Malfunction
Date Received
August 4, 2011
Date of Event
June 22, 2011
Report Date
July 5, 2011
Manufacturer
ALCON - IRVINE TECHNOLOGY CENTER
Product Code
HQC
PMA / PMN Number
K911808
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
FR
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

INVESTIGATION, INCLUDING ROOT CAUSE ANALYSIS, IS IN PROGRESS. A SUPPLEMENTAL MDR WILL BE FILED AS NECESSARY WHEN ADDITIONAL REPORTABLE INFO BECOMES AVAILABLE. (B)(4).

Description of Event or Problem · 1

A NURSE REPORTED THAT DURING SURGERY, AFTER THE PROBE HAD BEEN INSERTED INTO THE PT'S EYE, THE SYSTEM STOPPED WORKING. THEY TRIED REBOOTING WITHOUT SUCCESS. NOTHING APPEARED ON THE SCREEN AND ALL THE OUTLETS OF THE OPERATING ROOM HAD BLOWN. IN ORDER TO COMPLETE THE PROCEDURE, ANOTHER SYSTEM WAS BROUGHT IN AND USED. THE PROCEDURE WAS COMPLETED SUCCESSFULLY AND NO HARM TO THE PT WAS REPORTED. PT IDENTIFIERS WERE NOT DISCLOSED. THIS IS THE SECOND OF TWO REPORTS FROM THE SAME FACILITY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ACCURUS 800CS PHACOFRAGMENTATION SYSTEM HQC ALCON - IRVINE TECHNOLOGY CENTER ACCURUS NA

Patients

Seq Age Sex Outcome Treatment
1 UNK