FDA Adverse Event Malfunction Summary report: N

LAUREATE WORLD PHACO SYSTEM

MDR report key: 4152533 · Received October 6, 2014

Report

Report Number
2028159-2014-01832
Event Type
Malfunction
Date Received
October 6, 2014
Date of Event
September 12, 2014
Report Date
September 12, 2014
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
UNKNOWN

Narratives

Additional Manufacturer Narrative · 1

INVESTIGATION INCLUDING ROOT CAUSE ANALYSIS IS IN PROGRESS. A SUPPLEMENTAL MDR WILL BE FIELD 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 LOW PHACO PERFORMANCE DURING A SURGICAL PROCEDURE. THE SURGERY WAS COMPLETED WITH THE SAME SYSTEM AND ACCESSORIES. THERE WAS NO HARM TO THE PT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
622175 LAUREATE WORLD PHACO SYSTEM PHACOFRAGMENTATION SYSTEM HQC ALCON - IRVINE TECHNOLOGY CENTER LAUREATE NA

Patients

Seq Age Sex Outcome Treatment
1