FDA Adverse Event Malfunction Summary report: N

INFINITI VISION SYSTEM OZIL

MDR report key: 3912831 · Received May 14, 2014

Report

Report Number
2028159-2014-00888
Event Type
Malfunction
Date Received
May 14, 2014
Date of Event
April 29, 2014
Report Date
April 29, 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
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 INFO BECOMES AVAILABLE. (B)(4).

Description of Event or Problem · 1

A CUSTOMER REPORTED PRIOR TO STARTING A CATARACT EXTRACTION WITH INTRAOCULAR LENS IMPLANT PROCEDURE, THE FOOTSWITCH PRESENTED PROBLEMS AND THE SYSTEM LOCKED. THE SURGERY WAS COMPLETED USING AN ALTERNATE SYSTEM. THERE WAS NO IMPACT TO SCHEDULED PROCEDURES.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
288229 INFINITI VISION SYSTEM OZIL PHACOFRAGMENTATION SYSTEM HQC ALCON - IRVINE TECH CTR INFINITI OZIL NA

Patients

Seq Age Sex Outcome Treatment
1 INFINITI FOOTSWITCH