ACCURUS HIGH BRIGHTNESS ILLUMINATOR SYSTEM 8065750290

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 01,05 report with the FDA on 2012-10-08 for ACCURUS HIGH BRIGHTNESS ILLUMINATOR SYSTEM 8065750290 manufactured by Alcon - Irvine Technology Center.

Event Text Entries

[2915459] A customer reported the system displayed an error message and system locked during surgery. The customer changed the temperature sensor and cleaned the air filter. The system was exchanged and the procedure was completed with no harm to the patient.
Patient Sequence No: 1, Text Type: D, B5


[10212749] The company representative examined the system and confirmed the reported issue. The company representative replaced the lamp module thermistor. The company representative then performed general cleaning of the system air filters. Preventive maintenance was performed. The system was then tested and met all product specifications. No samples were returned for evaluation and no additional information provided related to this event. For this reason, steps could not be taken to replicate or confirm the reported event. A review of complaints for the last 24 months did not indicate any additional similar reports for this system. The root cause cannot be determined conclusively. (b)(4).
Patient Sequence No: 1, Text Type: N, H10


MAUDE Entry Details

Report Number2028159-2012-01519
MDR Report Key2784886
Report Source01,05
Date Received2012-10-08
Date of Report2012-09-06
Date of Event2012-09-01
Date Mfgr Received2012-09-06
Device Manufacturer Date2006-05-01
Date Added to Maude2012-11-02
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional3
Initial Report to FDA3
Report to FDA0
Event Location0
Manufacturer ContactPAUL NITSCHMANN
Manufacturer Street6201 SOUTH FREEWAY, R3-16
Manufacturer CityFORT WORTH TX 76134
Manufacturer CountryUS
Manufacturer Postal76134
Manufacturer Phone8176152440
Manufacturer G1ALCON - IRVINE TECHNOLOGY CENTER
Manufacturer Street15800 ALTON PKWY.
Manufacturer CityIRVINE CA 92618
Manufacturer CountryUS
Manufacturer Postal Code92618
Single Use3
Previous Use Code3
Removal Correction NumberNA
Event Type3
Type of Report3

Device Details

Brand NameACCURUS HIGH BRIGHTNESS ILLUMINATOR SYSTEM
Generic NameENDOILLUMINATOR
Product CodeMPA
Date Received2012-10-08
Model NumberNA
Catalog Number8065750290
Lot NumberNA
ID Number1.18 - 2.18
OperatorHEALTH PROFESSIONAL
Device AvailabilityY
Device AgeDA
Device Eval'ed by MfgrY
Device Sequence No1
Device Event Key0
ManufacturerALCON - IRVINE TECHNOLOGY CENTER
Manufacturer Address15800 ALTON PKWY. IRVINE CA 92618 US 92618


Patients

Patient NumberTreatmentOutcomeDate
10 2012-10-08

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