FDA Adverse Event Malfunction Summary report: N

LAUREATE WORLD PHACO SYSTEM

MDR report key: 3202009 · Received June 27, 2013

Report

Report Number
2028159-2013-01130
Event Type
Malfunction
Date Received
June 27, 2013
Date of Event
May 24, 2013
Report Date
June 3, 2013
Manufacturer
ALCON - IRVINE TECHNOLOGY CENTER
Product Code
HQC
PMA / PMN Number
K021566
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
BR
Reporter Occupation
OTHER

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

A CUSTOMER REPORTED THE EQUIPMENT DISPLAYED A SYSTEM MESSAGE DURING A CATARACT WITH INTRAOCULAR LENS IMPLANT PROCEDURE. FOLLOWING A DELAY GREATER THAN 15 MINUTES, THE PROCEDURE WAS COMPLETED WITH THE SAME EQUIPMENT AND A DIFFERENCE CASSETTE. THERE WAS NO HARM TO THE PT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
292365 LAUREATE WORLD PHACO SYSTEM PHACOFRAGMENTATION SYSTEM HQC ALCON - IRVINE TECHNOLOGY CENTER LAUREATE NA

Patients

Seq Age Sex Outcome Treatment
1