FDA Adverse Event Malfunction Summary report: N

INFINITI VISION SYSTEM OZIL

MDR report key: 2844570 · Received November 12, 2012

Report

Report Number
2028159-2012-01752
Event Type
Malfunction
Date Received
November 12, 2012
Date of Event
October 9, 2012
Report Date
October 10, 2012
Manufacturer
ALCON - IRVINE TECHNOLOGY CENTER
Product Code
HQC
PMA / PMN Number
K082845
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
BR
Reporter Occupation
NURSE

Narratives

Additional Manufacturer Narrative · 1

THE COMPANY REP EXAMINED THE SYSTEM AND REPLACED THE FOOTSWITCH, FOOTSWITCH CABLE, FOOTSWITCH INTERFACE PRINTED CIRCUIT BOARD (PCB), AND THE ULTRASOUND (U/S) CONTROLLER PCB. THE SYSTEM WAS THEN TESTED AND MET ALL PRODUCT SPECS. THERE WAS NO SAMPLE RETURNED FOR EVAL AND NO ADD'L INFO PROVIDED RELATED TO THIS EVENT. FOR THIS REASON, STEPS COULD NOT BE TAKEN TO REPLICATE OR CONFIRM THE REPORTED EVENT. A REVIEW OF COMPLAINTS FOR THE LAST 24 MONTHS DID NOT INDICATE ANY ADD'L RELATED REPORTS FOR THIS SYSTEM. THE ROOT CAUSE COULD NOT BE DETERMINED. (B)(4).

Description of Event or Problem · 1

A NURSE REPORTED DIFFICULTY PRIMING AND A SYSTEM MESSAGE DISPLAYED DURING A CATARACT EXTRACTION PROCEDURE. FOLLOWING A DELAY OF 40 MINUTES, THE PROCEDURE WAS COMPLETED WITH NO IMPACT TO THE PT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 INFINITI VISION SYSTEM OZIL PHACOFRAGMENTATION SYSTEM HQC ALCON - IRVINE TECHNOLOGY CENTER INFINITI OZIL NA

Patients

Seq Age Sex Outcome Treatment
1 INFINITI ENHANCED FOOTSWITCH