FDA Adverse Event Malfunction Summary report: N

INFINITI VISION SYSTEM OZIL

MDR report key: 3111816 · Received May 7, 2013

Report

Report Number
2028159-2013-00879
Event Type
Malfunction
Date Received
May 7, 2013
Date of Event
March 22, 2013
Report Date
April 15, 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
OH, US
Reporter Occupation
NURSE

Narratives

Additional Manufacturer Narrative · 1

THE COMPANY REPRESENTATIVE EXAMINED THE SYSTEM AND COULD NOT DUPLICATE THE REPORTED EVENT. THE SYSTEM WAS THEN TESTED AND MET ALL PRODUCT SPECIFICATIONS. THERE WAS NO SAMPLE RETURNED FOR EVALUATION AND NO ADDITIONAL INFO PROVIDED RELATED TO THIS EVENT. FOR THIS REASON, STEPS COULD NOT BE TAKEN TO REPLICATE OR CONFIRM THE REPORTED EVENT. A REVIEW OF THE SYSTEM'S EVENT LOG DID NOT INDICATE ANY RELATED SYSTEM MESSAGES. A REVIEW OF COMPLAINTS FOR THE LAST 24 MONTHS DID INDICATE 3 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 DURING A CATARACT EXTRACTION PROCEDURE, THE SURGEON EXPERIENCED VACUUM ISSUES DURING THE PHACOEMULSIFICATION MODE. THE SYSTEM WAS SWITCHED OUT TO COMPLETE THE CASE. THERE WAS NO HARM TO THE PT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
199865 INFINITI VISION SYSTEM OZIL PHACOFRAGMENTATION SYSTEM HQC ALCON - IRVINE TECHNOLOGY CENTER INFINITI OZIL NA

Patients

Seq Age Sex Outcome Treatment
1