FDA Adverse Event Malfunction Summary report: N

INFINITI VISION SYSTEM OZIL

MDR report key: 4121441 · Received July 29, 2014

Report

Report Number
2028159-2014-01398
Event Type
Malfunction
Date Received
July 29, 2014
Date of Event
June 30, 2014
Report Date
June 30, 2014
Manufacturer
ALCON - IRVINE TECHNOLOGY CENTER
Product Code
HQC
PMA / PMN Number
K082845
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
AS
Reporter Occupation
NURSE

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 NURSE REPORTED THAT SALINE SOLUTION LEAKED AND THE SYSTEM'S SAFETY SWITCH CUT THE POWER TO THE SYSTEM DURING A SURGICAL PROCEDURE. THE PROCEDURE WAS COMPLETED WITH A BACKUP SYSTEM. THERE WAS NO HARM TO THE PT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
442825 INFINITI VISION SYSTEM OZIL PHACOFRAGMENTATION SYSTEM HQC ALCON - IRVINE TECHNOLOGY CENTER INFINITI OZIL NA

Patients

Seq Age Sex Outcome Treatment
1