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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ALCON RESEARCH, LLC - HOUSTON CENTURION SURGICAL PROCEDURE PAK; GENERAL SURGERY TRAY (KIT)

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ALCON RESEARCH, LLC - HOUSTON CENTURION SURGICAL PROCEDURE PAK; GENERAL SURGERY TRAY (KIT) Back to Search Results
Catalog Number 8065752203
Medical Device Problem Code Suction Problem (2170)
Health Effect - Clinical Code Insufficient Information (4580)
Date of Event 12/17/2025
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
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.The manufacturer internal reference number is: (b)(4).
 
Event or Problem Description
A pharmacist reported that the defective aspiration occurred during surgery.The procedure type and other surgery details were unknown.There was no information about patient impact.
 
Additional Manufacturer Narrative
Additional information provided in d.9., h.3., h.6.And h.11.One turbid fluid management system (fms) in the tray was visually inspected.The drain bag was detached from the drain bag tape on the cover due to saturation.The drain bag tape was adhered on the cassettes properly.Both irrigation and aspiration luers were intact.Flare shape was observed in the blue socket fitting at the aspiration tubing insertion end.The product was tested using the console with the current software procedure.The product could be recognized by the console.The product primed and tuned with the sentry handpiece and the 0.9 milli meter aspiration bypass system (ab)s tip and infusion sleeve from the lab stock, successfully and the service data could be retrieved.No system message code displayed on console screen.Neither leakage, nor occlusion was detected from the tubing insertion to the fittings and the four aspiration ports on the pump region of the cassette base.Cassette maximum vacuum and aspiration flow rates, and irrigation flow rates were measured and met specifications.The product functioned within specification per procedure.The investigation conducted a non-conformance review of the reported lot number.No deviations that could have contributed to this event were identified and all corresponding production release specifications defined in the device master record were met.The product passed functionality per procedure.The root cause of the customer's complaint could not be established; the returned sample functioned per specifications.No contributing factors could be identified that could cause the customer¿s experience.No further investigative or manufacturing actions are warranted at this time due to the product meeting specifications.Receipt of additional relevant information or supporting materials will prompt a re-evaluation of the complaint investigation.Complaint data for all company products is reviewed monthly to monitor for adverse trends.During the last review, no adverse trends were observed for the reported product and event combination.Quality assurance has reviewed this complaint and will continue to monitor data for evidence of adverse trending and take further action, as appropriate.No further action warranted at this time.The manufacturer internal reference number is: (b)(4).
 
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Brand Name
CENTURION SURGICAL PROCEDURE PAK
Common Device Name
GENERAL SURGERY TRAY (KIT)
Manufacturer (Section D)
ALCON RESEARCH, LLC - HOUSTON
9965 buffalo speedway
houston TX 77054
Manufacturer (Section G)
ALCON RESEARCH, LLC - HOUSTON
9965 buffalo speedway
houston TX 77054
Manufacturer Contact
jonathan schlech
6201 south freeway
mail stop ab2-6
fort worth, TX 76134
8007579780
MDR Report Key24105458
Report Number1644019-2026-00393
Device Sequence Number10214840
Product Code LRO
UDI-Device Identifier00380657522033
UDI-Public(01)00380657522033(17)270731(11)250817(10)17L3TN
Combination Product (Y/N)N
Initial Reporter CountryFR
PMA/510(K) Number
K880961
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source Foreign,Health Professional,Company Representative
Initial Reporter Occupation Pharmacist
Type of Report Initial,Followup
Report Date (Section B) 05/21/2026
1 Device was Involved in the Event
1 Patient was Involved in the Event
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Operator of Device Health Professional
Device Catalogue Number8065752203
Device Lot Number17L3TN
Was Device Available for Evaluation? Device Returned to Manufacturer
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Initial
Initial Date Received by Manufacturer 12/23/2025
Supplement Date Received by Manufacturer04/28/2026
Initial Report FDA Received Date01/17/2026
Supplement Report FDA Received Date05/21/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured08/17/2025
Is This a Single-Use Device that was
Reprocessed and Reused on a Patient? (Y/N)
No
Usage of Device Initial
Patient Sequence Number1
Patient SexUnknown
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