FDA Adverse Event Malfunction Summary report: N

PUREPOINT

MDR report key: 4152535 · Received October 6, 2014

Report

Report Number
2028159-2014-01831
Event Type
Malfunction
Date Received
October 6, 2014
Date of Event
September 11, 2014
Report Date
September 11, 2014
Manufacturer
ALCON - IRVINE TECHNOLOGY CENTER
Product Code
HQF
PMA / PMN Number
K062624
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
AS
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 THERE WAS LOW ENERGY DURING A LASER PROCEDURE. THE SURGEON HAD TO INCREASE THE POWER TO COMPLETE THE PROCEDURE. THERE WAS NO PT HARM.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
622122 PUREPOINT LASER, OPHTHALMIC HQF ALCON - IRVINE TECHNOLOGY CENTER PUREPOINT NA

Patients

Seq Age Sex Outcome Treatment
1