LIGHT PIPE 5026098X-2005-10 *

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2006-01-12 for LIGHT PIPE 5026098X-2005-10 * manufactured by Alcon Laboratories,inc..

Event Text Entries

[20508894] The light fiber was loose and could be pulled apart. It was removed off the field and sent to biomed for evaluation.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number679443
MDR Report Key679443
Date Received2006-01-12
Date of Report2006-01-12
Date of Event2005-11-28
Report Date2006-01-12
Date Reported to FDA2006-01-12
Date Added to Maude2006-03-01
Event Key0
Report Source CodeUser Facility report
Manufacturer LinkN
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag0
Reporter OccupationRISK MANAGER
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Single Use0
Previous Use Code0
Event Type3
Type of Report3

Device Details

Brand NameLIGHT PIPE
Generic NameSURGICAL LIGHT
Product CodeFCT
Date Received2006-01-12
Model Number5026098X-2005-10
Catalog Number*
Lot Number*
ID Number*
OperatorPHYSICIAN
Device AvailabilityY
Implant FlagN
Date Removed*
Device Sequence No1
Device Event Key668711
ManufacturerALCON LABORATORIES,INC.
Manufacturer Address6201 SOUTH FREEWAY; MAIL STOP FORTH WORTH TX 76134 US


Patients

Patient NumberTreatmentOutcomeDate
10 2006-01-12

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