FDA Adverse Event Malfunction Summary report: N

INFINITI VISION SYSTEM OZIL

MDR report key: 3043006 · Received March 7, 2013

Report

Report Number
2028159-2013-00399
Event Type
Malfunction
Date Received
March 7, 2013
Date of Event
February 8, 2013
Report Date
February 8, 2013
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
GA, US
Reporter Occupation
NURSE

Narratives

Additional Manufacturer Narrative · 1

THE COMPANY REPRESENTATIVE EXAMINED THE SYSTEM AND WAS UNABLE TO REPLICATE THE REPORTED ISSUE. PREVENTIVE MAINTENANCE (PM) WAS PERFORMED. THE SYSTEM SOFTWARE WAS UPDATED, WHICH IS UNRELATED TO CUSTOMER REPORTED ISSUE. 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 NURSE REPORTED THAT A SYSTEM MESSAGE DISPLAYED AND THE VITRECTOMY PROBE WAS NOT WORKING DURING A SURGERY. THE PROBE AND THE SYSTEM WERE SWITCHED OUT AND THE CASE WAS COMPLETED WITH NO IMPACT TO THE PT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
98510 INFINITI VISION SYSTEM OZIL PHACOFRAGMENTATION SYSTEM HQC ALCON - IRVINE TECHNOLOGY CENTER INFINITI OZIL NA

Patients

Seq Age Sex Outcome Treatment
1