SOFT I/A S-IA-02020

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a user facility report with the FDA on 2018-06-21 for SOFT I/A S-IA-02020 manufactured by Microsurgical Technology, Inc..

Event Text Entries

[112463218] The device was evaluated and it was found that the hub of the cannula was damaged. The hub appeared to have been gripped by forceps or pliers to tighten and/or loosen the tip onto the handpieces. The gripping caused the metal to strip off and be introduced into the eye. The metal piece was easily aspirated from the eye and there was no patient impact.
Patient Sequence No: 1, Text Type: N, H10


[112463219] Customer reported that during cataract surgery the patient had a particle in the anterior chamber. There was no patient impact and the particle was aspirated from the eye.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number3019924-2018-00020
MDR Report Key7626353
Report SourceUSER FACILITY
Date Received2018-06-21
Date of Report2018-06-21
Date of Event2018-06-06
Date Mfgr Received2018-06-06
Date Added to Maude2018-06-21
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 FDA3
Event Location3
Manufacturer ContactMR. CECIL CHRISINGER
Manufacturer Street8415 154TH AVE NE
Manufacturer CityREDMOND WA 98052
Manufacturer CountryUS
Manufacturer Postal98052
Manufacturer G1MICROSURGICAL TECHNOLOGY, INC.
Manufacturer Street8415 154TH AVE NE
Manufacturer CityREDMOND WA 98052
Manufacturer CountryUS
Manufacturer Postal Code98052
Single Use3
Remedial ActionRL
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameSOFT I/A
Generic NameOPHTHALMIC CANNULA
Product CodeHMX
Date Received2018-06-21
Returned To Mfg2018-06-19
Model NumberS-IA-02020
Catalog NumberS-IA-02020
OperatorPHYSICIAN
Device AvailabilityR
Device Eval'ed by MfgrY
Device Sequence No1
Device Event Key0
ManufacturerMICROSURGICAL TECHNOLOGY, INC.
Manufacturer Address8415 154TH AVE NE REDMOND WA 98052 US 98052


Patients

Patient NumberTreatmentOutcomeDate
10 2018-06-21

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