FDA Adverse Event Malfunction Summary report: N

INFINITI VISION SYSTEM OZIL

MDR report key: 3834550 · Received March 19, 2014

Report

Report Number
2028159-2014-00458
Event Type
Malfunction
Date Received
March 19, 2014
Date of Event
February 20, 2014
Report Date
February 20, 2014
Manufacturer
ALCON - IRVINE TECH CTR
Product Code
HQC
PMA / PMN Number
K082845
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
JA
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

A SAMPLE HAS BEEN RECEIVED AND IN-HOUSE TESTING IS IN PROGRESS. 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 INFO BECOMES AVAILABLE. (B)(4).

Description of Event or Problem · 1

A SURGEON REPORTED POOR ASPIRATION DURING A PROCEDURE. THE CASE WAS COMPLETED WITH AN ALTERNATE HANDPIECE. THERE WAS NO HARM TO THE PT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
162648 INFINITI VISION SYSTEM OZIL PHACOFRAGMENTATION SYSTEM HQC ALCON - IRVINE TECH CTR INFINITI OZIL NA

Patients

Seq Age Sex Outcome Treatment
1 UNK I/A HANDPIECE