FDA Adverse Event Malfunction Summary report: N

ACCURUS 600DS

MDR report key: 3043000 · Received March 7, 2013

Report

Report Number
2028159-2013-00389
Event Type
Malfunction
Date Received
March 7, 2013
Date of Event
February 1, 2013
Report Date
February 5, 2013
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
BR
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THE COMPANY REPRESENTATIVE EXAMINED THE SYSTEM AND CONFIRMED THE PROBLEM REPORTED. THE LOW PRESSURE AIR SOURCE ASSEMBLY AND THE LPAS/ILLUMINATOR CONTROLLER ASSEMBLY WERE REPLACED. THE COMPANY REPRESENTATIVE ALSO REPLACED THE 3V ACCURUS BATTERY TO ADDRESS THE CPU BATTERY NONCONFORMITY. THE SYSTEM WAS THEN TESTED AND MET ALL PRODUCT SPECIFICATIONS. THERE WAS NO SAMPLE RETURNED FOR EVALUATION AND NO ADDITIONAL INFORMATION 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 ADDITIONAL SIMILAR REPORTS FOR THIS SYSTEM. THE ROOT CAUSE CANNOT BE DETERMINED CONCLUSIVELY. (B)(4).

Description of Event or Problem · 1

A CUSTOMER REPORTED THAT THE FLUID/GAS EXCHANGE DID NOT FUNCTION AND AN "ERROR OCCURRED IN THE CPU" DURING THE PROCEDURE. THE PROCEDURE WAS COMPLETED WITH AN ALTERNATE SYSTEM WITH NO IMPACT TO THE PT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
98509 ACCURUS 600DS PHACOFRAGMENTATION SYSTEM HQC ALCON - IRVINE TECHNOLOGY CENTER ACCURUS NA

Patients

Seq Age Sex Outcome Treatment
1