FDA Adverse Event Malfunction Summary report: N

INFINITI VISION SYSTEM OZIL

MDR report key: 2903333 · Received December 14, 2012

Report

Report Number
2028159-2012-01953
Event Type
Malfunction
Date Received
December 14, 2012
Report Date
November 16, 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
TX, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

INVESTIGATION INCLUDING ROOT CAUSE ANALYSIS IS IN PROGRESS. A SUPPLEMENTAL MDR WILL BE FILED AS NECESSARY IN ACCORDANCE WITH 21 CFR 803.56 WHEN ADDITIONAL REPORTABLE INFORMATION BECOMES AVAILABLE. (B)(4).

Description of Event or Problem · 1

A CUSTOMER REPORTED THAT A SYSTEM MESSAGE DISPLAYED AND WAS UNABLE TO BE CLEARED DURING A CATARACT EXTRACTION PROCEDURE. THE PROCEDURE WAS COMPLETED MANUALLY WITH NO HARM TO THE PATIENT.

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 Required Intervention