WAVESCAN ADVANCED CUSTOMVUE ACV 0070-1478

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 06,07 report with the FDA on 2012-12-04 for WAVESCAN ADVANCED CUSTOMVUE ACV 0070-1478 manufactured by Abbott Medical Optics.

Event Text Entries

[2984966] The customer reported that the computer will not boot up and the monitor is displaying a blue screen. Amo field service went on site and reported that the power supply emitted smoke when powered on.
Patient Sequence No: 1, Text Type: D, B5


[10260553] The amo field service specialist evaluated the system at the customer location and found the computer would not turn on. Field service mentioned that he observed smoke coming from the computer power supply. The field service specialist replaced the computer and verified the system was operational to device specifications following the repair. All pertinent information available to amo has been submitted.
Patient Sequence No: 1, Text Type: N, H10


MAUDE Entry Details

Report Number3006695864-2012-00184
MDR Report Key2856628
Report Source06,07
Date Received2012-12-04
Date of Report2012-11-07
Date of Event2012-11-07
Date Mfgr Received2012-11-07
Device Manufacturer Date2007-07-19
Date Added to Maude2012-12-04
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Reporter OccupationOTHER HEALTH CARE PROFESSIONAL
Health Professional3
Initial Report to FDA3
Report to FDA0
Event Location0
Manufacturer ContactCAROL KAIL
Manufacturer Street1700 EAST ST. ANDREW PLACE
Manufacturer CitySANTA ANA CA 92705
Manufacturer CountryUS
Manufacturer Postal92705
Manufacturer Phone7142478675
Manufacturer G1ABBOTT MEDICAL OPTICS INC.
Manufacturer StreetAMO MANUFACTURING 510 COTTONWOOD
Manufacturer CityMILPITAS CA 95035
Manufacturer CountryUS
Manufacturer Postal Code95035
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameWAVESCAN ADVANCED CUSTOMVUE
Generic NameREFRACTIVE MEASUREMENT
Product CodeHKO
Date Received2012-12-04
Model NumberACV
Catalog Number0070-1478
OperatorOTHER HEALTH CARE PROFESSIONAL
Device AvailabilityY
Device Eval'ed by MfgrY
Device Sequence No1
Device Event Key0
ManufacturerABBOTT MEDICAL OPTICS
Manufacturer AddressSANTA ANA CA


Patients

Patient NumberTreatmentOutcomeDate
10 2012-12-04

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