BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    OPMI 1 FC ON S100 FLOOR STAND

    MDR report key: 2746944 · Received September 12, 2012

    Report

    Report Number
    9615010-2012-00009
    Event Type
    Malfunction
    Date Received
    September 12, 2012
    Date of Event
    August 13, 2012
    Report Date
    September 10, 2012
    Manufacturer
    CARL ZEISS MEDITEC AG (OBERKOCHEN SITE)
    Product Code
    EPT
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    NC, US
    Reporter Occupation
    BIOMEDICAL ENGINEER

    Narratives

    Additional Manufacturer Narrative · 1

    A FIELD SERVICE ENGINEER EXAMINED THE TILT COUPLING AND FOUND THAT THE OUTER THREADED RING THAT SECURES THE COUPLING INTERNAL COMPONENTS TO THE COUPLING BODY WAS FULLY UNSCREWED. THIS THREADED RING IS SECURED AT THE FACTORY AND IS NOT INTENDED TO BE LOOSENED. IF THE RING BECOMES FULLY UNSCREWED, THE INTERNAL COMPONENTS (AND MICROSCOPE HEAD IF ATTACHED) ARE ABLE TO SEPARATE AND FALL OUT OF THE COUPLING BODY. AFTER CONFIRMING THERE WAS NO DAMAGE TO THE COMPONENTS, THE ENGINEER REINSTALLED THE THREADED RING WITH LOCTITE APPLIED TO THE THREADS AND TIGHTENED TO SPECIFICATION. IN A FOLLOW-UP VISIT, THE FIELD SERVICE ENGINEER FOUND THAT THE USER ADJUSTABLE INTERNAL SECURING SCREW THAT IS USED TO SECURE THE MICROSCOPE HEAD ROTATION SHAFT TO THE TILT COUPLING WAS MISSING AS WAS THE SCREW¿S PROTECTIVE CAP. REPLACEMENT PARTS WERE ORDERED. THE CUSTOMER INDICATED THAT THEIR BIOMEDICAL ENGINEERING DEPARTMENT HAD PERFORMED SERVICE ON THIS MICROSCOPE ON A FEW OCCASIONS SINCE THE LAST PREVENTIVE MAINTENANCE IN (B)(4) 2011. THE TILT COUPLING INSTRUCTIONS FOR USE PROVIDES THE USER WITH DETAILED INSTRUCTIONS ON MOUNTING/DISMOUNTING OF THE TILT COUPLING TO THE STAND AND MOUNTING/DISMOUNTING OF THE MICROSCOPE ROTATING SHAFT TO THE TILT COUPLING.

    Description of Event or Problem · 1

    DURING A SURGICAL PROCEDURE FOR TONSILLITIS THE OPMI 1-FC MICROSCOPE HEAD AND AN INTERNAL PART OF THE TILT COUPLING SEPARATED FROM THE TILT COUPLING BODY (ATTACHED TO THE S100 FLOOR STAND) AND FELL INTO THE DOCTOR¿S HANDS. THE SURGERY WAS COMPLETED USING AN ALTERNATE MICROSCOPE. NO ONE WAS INJURED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 OPMI 1 FC ON S100 FLOOR STAND SURGICAL MICROSCOPE EPT CARL ZEISS MEDITEC AG (OBERKOCHEN SITE) NA

    Patients

    Seq Age Sex Outcome Treatment
    1