FDA Adverse Event Malfunction Summary report: N

AMO PRESTIGE UNIT, PROFINESSE ULTRASONIC HAND PIECE

MDR report key: 6552 · Received August 18, 1993

Report

Report Number
6552
Event Type
Malfunction
Date Received
August 18, 1993
Date of Event
June 16, 1993
Manufacturer
ALLERGAN MEDICAL OPTICS
Product Code
HQE
Product Problem
Yes
Report Source
User Facility report

Narratives

Description of Event or Problem · 1

DURING CATARACT EXTRACTION, PT SUFFERED CORNEAL BURN. THIS EVENT WAS NOT KNOWN TO RISK MGMT DEPT UNTIL SEVERAL HRS AFTER THE EVENT. HAND PIECE AND TUBING WITH EQUIPMENT WERE TAKEN BY SALES REP AFTER THE PROCEDURE. QA BY CO REPORTED NO PROBLEMS WITH THE EQUIPMENT. CAUSE OF BURN UNKNOWN. OUTCOME OF PT IS STILL UNKNOWN AT THIS TIME. MD STATES COULD MINIMAL OR SERIOUS.DEVICE NOT LABELED FOR SINGLE USE. PATIENT MEDICAL STATUS PRIOR TO EVENT: SATISFACTORY CONDITION. THERE WAS NOT MULTIPLE PATIENT INVOLVEMENT.INVALID DATA - ON DEVICE SERVICE/MAINTENANCE. NO DATA - REGARDING DATE LAST SERVICED. SERVICE PROVIDED BY: INVALID DATA. INVALID DATA - SERVICE RECORDS AVAILABILITY.NO IMMINENT HAZARD TO PUBLIC HEALTH CLAIMED. DEVICE USED AS LABELED/INTENDED.DEVICE WAS EVALUATED AFTER THE EVENT. METHOD OF EVALUATION: ACTUAL DEVICE INVOLVED IN INCIDENT WAS EVALUATED, NONE OR UNKNOWN. RESULTS OF EVALUATION: NONE OR UNKNOWN. CONCLUSION: NONE OR UNKNOWN. CERTAINTY OF DEVICE AS CAUSE OF OR CONTRIBUTOR TO EVENT: INVALID DATA. CORRECTIVE ACTIONS: DEVICE RETURNED TO MANUFACTURER/DEALER/DISTRIBUTOR. THE DEVICE WAS NOT DESTROYED/DISPOSED OF.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 AMO PRESTIGE UNIT, PROFINESSE ULTRASONIC HAND PIECE UNKNOWN HQE ALLERGAN MEDICAL OPTICS UNKNOWN OPO40 IRRIGATION SET 135DR3

Patients

Seq Age Sex Outcome Treatment
1 85 YR Other