| Brand Name | Viscous Fluid Control Tubing Set (Silicone Oil Inj/Ext) |
| Common Device Name | Tubing, noninvasive |
| 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
|
|
+1(800)757-9780
|
|
| MDR Report Key | 50686483 |
| Report Number | 1644019-2026-04680 |
| Device Sequence Number | 10349335 |
| Product Code |
GAZ
|
| UDI-Device Identifier | 00380657509577 |
| Combination Product (Y/N) | N |
| Initial Reporter Country | CH |
| PMA/510(K) Number | EXEMPT |
| Number of Events Summarized | 1 |
| Summary Report (Y/N) | N |
| Reporter Type |
Manufacturer
|
| Report Source |
Foreign,Health Professional,Company Representative |
| Initial Reporter Occupation |
Physician
|
| Type of Report
| Initial |
| Report Date (Section B) |
09/09/2026 |
| 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 Expiration Date | 08/31/2026 |
| Device Catalogue Number | 8065750957 |
| Device Lot Number | 171T65 |
| Was Device Available for Evaluation? |
No
|
| Is the Reporter a Health Professional? |
Yes
|
| Initial Date Received by Manufacturer | 08/20/2026 |
| Initial Report FDA Received Date | 09/09/2026 |
| Date Device Manufactured | 09/12/2024 |
Is This a Single-Use Device that was Reprocessed and Reused on a Patient? (Y/N) |
No
|
| Usage of Device |
Initial
|
| Patient Sequence Number | 1 |
| Patient Sex | Unknown |
|
|