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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ALCON RESEARCH, LTD. - IRVINE TECHNOLOGY CENTER LASER PROBES; INSTRUMENT, VITREOUS ASPIRATION AND CUTTING, AC-POWERED

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ALCON RESEARCH, LTD. - IRVINE TECHNOLOGY CENTER LASER PROBES; INSTRUMENT, VITREOUS ASPIRATION AND CUTTING, AC-POWERED Back to Search Results
Catalog Number 8065751593
Device Problem Sticking (1597)
Patient Problem No Known Impact Or Consequence To Patient (2692)
Event Type  malfunction  
Manufacturer Narrative
The sample has been received and in-house evaluation is in progress.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).
 
Event Description
A customer reported that during surgery, on multiple occasions, the curved laser probe stuck when inserting inside the trocar.The probe was switched out on each case to complete surgery.There was no patient harm.
 
Manufacturer Narrative
Additional information provided.Two 25 gauge illuminated flex curved laser probe were received.A visual assessment of the first sample revealed no nonconformity.A visual assessment of the second sample revealed adhesive on the cannula tip.Each 25 gauge illuminated flex curved laser probe was inserted into a 25g trocar.The first sample had no resistance when inserted into the 25g trocar.The second sample became stuck when inserted through the 25g trocar, confirming the reported event.Additionally, the samples cannula outer diameters (od) were measured.With an od min/max values of 0.0200 to 0.0205 inches, the first sample¿s od was measured to be 0.02030 to 0.02035, meeting specifications.The second sample¿s od was measured to be 0.02030-0.02020, also not meeting specifications.Based on qa assessment, both products met specifications at the time of release.The root cause of the reported event can be attributed to excess adhesive residue on the laser probe tip during manufacturing.An internal investigation has been opened.The manufacturer internal reference number is: (b)(4).
 
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Brand Name
LASER PROBES
Type of Device
INSTRUMENT, VITREOUS ASPIRATION AND CUTTING, AC-POWERED
Manufacturer (Section D)
ALCON RESEARCH, LTD. - IRVINE TECHNOLOGY CENTER
15800 alton parkway
irvine CA 92618
Manufacturer (Section G)
ALCON RESEARCH, LTD. - IRVINE TECHNOLOGY CENTER
15800 alton parkway
irvine CA 92618
Manufacturer Contact
bryan blake
6201 south freeway
mail stop ab2-6
fort worth, TX 76134
8176152230
MDR Report Key7450391
MDR Text Key106386449
Report Number2028159-2018-00822
Device Sequence Number1
Product Code HQE
Combination Product (y/n)N
Reporter Country CodeCA
PMA/PMN Number
K946135
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type company representative,foreig
Reporter Occupation Other
Remedial Action Other
Type of Report Initial,Followup
Report Date 05/17/2018
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received04/23/2018
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Operator Health Professional
Device Expiration Date06/30/2019
Device Catalogue Number8065751593
Device Lot Number17025690X
Other Device ID Number380657515936
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer02/05/2018
Is the Reporter a Health Professional? No
Date Manufacturer Received05/09/2018
Was Device Evaluated by Manufacturer? Yes
Date Device Manufactured07/11/2017
Is the Device Single Use? Yes
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Initial
Patient Sequence Number1
Patient Outcome(s) Other;
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