| Brand Name | Backflush Handle DSP |
| Common Device Name | Instrument, Vitreous Aspiration and Cutting, AC-Powered, Accessory |
| Manufacturer (Section D) |
| Alcon Grieshaber AG |
| winkelriedstrasse 52 |
| schaffhausen 8203 |
| SZ 8203 |
|
| Manufacturer (Section G) |
| Alcon Grieshaber AG |
| winkelriedstrasse 52 |
|
| schaffhausen 8203 |
|
SZ
8203
|
|
| Manufacturer Contact |
|
jonathan
schlech
|
| 6201 south freeway |
| mail stop ab2-6 |
| fort worth, TX 76134
|
|
+1(800)757-9780
|
|
| MDR Report Key | 50745345 |
| Report Number | 3003398873-2026-00189 |
| Device Sequence Number | 8450323 |
| Product Code |
HQE
|
| UDI-Device Identifier | 07612717071193 |
| UDI-Public | (01)07612717071193(17)290131(11)260216(10)17XW79 |
| Combination Product (Y/N) | N |
| Initial Reporter Country | KS |
| PMA/510(K) Number | K884043 |
| Number of Events Summarized | 1 |
| Summary Report (Y/N) | N |
| Reporter Type |
Manufacturer
|
| Report Source |
Foreign,Health Professional,Company Representative |
| Initial Reporter Occupation |
Nurse
|
| Type of Report
| Initial |
| Report Date (Section B) |
09/11/2026 |
| 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 Number | 337.84 |
| Device Lot Number | 17XW79 |
| Was Device Available for Evaluation? |
No
|
| Is the Reporter a Health Professional? |
Yes
|
| Initial Date Received by Manufacturer | 08/18/2026 |
| Initial Report FDA Received Date | 09/12/2026 |
| Date Device Manufactured | 02/16/2026 |
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 |
|
|