FDA Adverse Event Malfunction Summary report: N

INFINITI VISION SYS OZIL

MDR report key: 4173188 · Received October 10, 2014

Report

Report Number
2028159-2014-01883
Event Type
Malfunction
Date Received
October 10, 2014
Date of Event
September 15, 2014
Report Date
September 15, 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
BR
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 INFO BECOMES AVAILABLE. (B)(4).

Description of Event or Problem · 1

A CUSTOMER REPORTED THAT DURING SETUP FOR A CATARACT PROCEDURE, THE PHACO ULTRASOUND DID NOT WORK. THERE WAS NO PT INVOLVEMENT. THE SYS WAS SWITCHED OUT TO PROCEED WITH SURGERY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
642705 INFINITI VISION SYS OZIL PHACOFRAGMENTATION SYS HQC ALCON - IRVINE TECHNOLOGY CTR INFINITI OZIL NA

Patients

Seq Age Sex Outcome Treatment
1 NA