FDA Adverse Event Malfunction Summary report: N

LENSX LASER SYSTEM

MDR report key: 2945240 · Received February 1, 2013

Report

Report Number
3008772169-2013-00006
Event Type
Malfunction
Date Received
February 1, 2013
Date of Event
January 3, 2013
Report Date
January 3, 2013
Manufacturer
ALCON - LENSX LASERS INC.
Product Code
OOE
PMA / PMN Number
K101626
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NC, US
Reporter Occupation
UNKNOWN

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

WHILE ON SITE TO SERVICE THE LASER, THE COMPANY FSE (FIELD SERVICE ENGINEER) NOTED THAT THE GANTRY MOVED DOWNWARD ON ITS OWN WHEN THERE WAS NO POWER TO THE SYSTEM. THERE WAS NOT PT INVOLVED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
44439 LENSX LASER SYSTEM OPHTHALMIC FEMTOSECOND LASER OOE ALCON - LENSX LASERS INC. 550 NA

Patients

Seq Age Sex Outcome Treatment
1