FDA Adverse Event Malfunction Summary report: N

INFINITI VISION SYSTEM OZIL

MDR report key: 4042168 · Received July 8, 2014

Report

Report Number
2028159-2014-01127
Event Type
Malfunction
Date Received
July 8, 2014
Date of Event
June 9, 2014
Report Date
June 9, 2014
Manufacturer
ALCON - IRVINE TECHNOLOGY CTR
Product Code
HQC
PMA / PMN Number
K082845
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
FL, US
Reporter Occupation
UNKNOWN

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 THAT A FOOTSWITCH DID NOT COMMUNICATE WITH THE SYSTEM BEFORE A PROCEDURE. THE SYSTEM WAS EXCHANGED TO START AND COMPLETE THE CASE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
398476 INFINITI VISION SYSTEM OZIL PHACOFRAGMENTATION SYSTEM HQC ALCON - IRVINE TECHNOLOGY CTR INFINITI OZIL NA

Patients

Seq Age Sex Outcome Treatment
1 INFINITI ENHANCED FOOTSWITCH