FDA Adverse Event Malfunction Summary report: N

INFINITI VISION SYSTEM OZIL

MDR report key: 3190664 · Received June 21, 2013

Report

Report Number
2028159-2013-01201
Event Type
Malfunction
Date Received
June 21, 2013
Date of Event
May 22, 2013
Report Date
May 22, 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
BR
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

A REVIEW OF THE SERVICE REPORT INDICATES THE CUSTOMER REPORTED THEIR SYSTEM DISPLAYED A SYSTEM MESSAGE (SM) "UNKNOWN FOOTSWITCH TYPE IS DETECTED". THE COMPANY REPRESENTATIVE EXAMINED THE SYSTEM. THE FOOTSWITCH, FOOTSWITCH CABLE, AND FOOTSWITCH INTERFACE PRINTED CIRCUIT BOARD (PCB) WERE REPLACED. THE SOFTWARE WAS UPDATED. 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 (B)(4) 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 SYSTEM DISPLAYED A SYSTEM MESSAGE AND LOCKED PRIOR TO A PROCEDURE. THE SCHEDULED PROCEDURE WAS NOT COMPLETED ALTHOUGH THE PATIENT HAD ALREADY RECEIVED PERIBULBAR ANESTHESIA. ALL REMAINING SCHEDULED CASES WERE CANCELED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
284126 INFINITI VISION SYSTEM OZIL PHACOFRAGMENTATION SYSTEM HQC ALCON - IRVINE TECHNOLOGY CENTER INFINITI OZIL NA

Patients

Seq Age Sex Outcome Treatment
1