OPMI PENTERO 302582-9901-000

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a health professional,user faci report with the FDA on 2017-11-21 for OPMI PENTERO 302582-9901-000 manufactured by Carl Zeiss Meditec Ag (oberkochen).

Event Text Entries

[92712508] During investigation of this event, the health care professional (hcp) indicated that the light intensity start value for the microscope was set to 76%. The hcp further stated that the patient's skin was exposed to the xenon light for 1 hour, 20 minutes at a focal distance of 250 mm. High light intensity supports a burn of surrounding tissue, especially if a short focal distance is used for a long duration. The user manual (g-30-1458-en, issue 9. 1, pages 22-24) discusses in detail the different factors that can influence the risk of burns and recommends measures to prevent them. - (b)(4).
Patient Sequence No: 1, Text Type: N, H10


[92712509] The health care professional (hcp) reported that a patient sustained a third degree burn during a tympanomastoidectomy procedure in which an opmi pentero microscope was used. The 2. 0 x 2. 5 cm burn was located on the back of the ear above the surgical area. The burn was recognized intraoperatively and required excision and repair.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number9615010-2017-00013
MDR Report Key7051109
Report SourceHEALTH PROFESSIONAL,USER FACI
Date Received2017-11-21
Date of Report2017-10-24
Date of Event2017-10-24
Date Mfgr Received2017-10-24
Device Manufacturer Date2007-12-18
Date Added to Maude2017-11-21
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag0
Reprocessed and Reused Flag3
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer ContactMR. WILLIAM GUSTAFSON
Manufacturer Street5160 HACIENDA DRIVE
Manufacturer CityDUBLIN CA 94568
Manufacturer CountryUS
Manufacturer Postal94568
Manufacturer Phone9255574689
Manufacturer G1CARL ZEISS MEDITEC AG (OBERKOCHEN)
Manufacturer StreetRUDOLF-EBER-STRASSE 11
Manufacturer CityOBERKOCHEN, BADEN-WUERTTEMBERG 73447
Manufacturer CountryGM
Manufacturer Postal Code73447
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Sequence Number: 0

Brand NameOPMI PENTERO
Generic NameMICROSCOPE, SURGICAL, GENERAL & PLASTIC SURGERY
Product CodeEPT
Date Received2017-11-21
Model NumberNA
Catalog Number302582-9901-000
Lot NumberNA
OperatorHEALTH PROFESSIONAL
Device AvailabilityY
Device Eval'ed by MfgrY
Device Sequence No0
Device Event Key0
ManufacturerCARL ZEISS MEDITEC AG (OBERKOCHEN)
Manufacturer AddressRUDOLF-EBER-STRASSE 11 OBERKOCHEN, BADEN-WUERTTEMBERG 73447 GM 73447

Device Sequence Number: 1

Brand NameOPMI PENTERO
Generic NameMICROSCOPE, SURGICAL, GENERAL & PLASTIC SURGERY
Product CodeFSO
Date Received2017-11-21
Model NumberNA
Catalog Number302582-9901-000
Lot NumberNA
OperatorHEALTH PROFESSIONAL
Device AvailabilityY
Device Eval'ed by MfgrY
Device Sequence No1
Device Event Key0
ManufacturerCARL ZEISS MEDITEC AG (OBERKOCHEN)
Manufacturer AddressRUDOLF-EBER-STRASSE 11 OBERKOCHEN, BADEN-WUERTTEMBERG 73447 GM 73447


Patients

Patient NumberTreatmentOutcomeDate
101. Congenital Not Applicablenomaly; 2. Required No Informationntervention 2017-11-21

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