MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a other,user facility report with the FDA on 2018-12-14 for EDGEPLUS VALVED ENTRY SYSTEM 8065751585 manufactured by Alcon Research, Ltd. - Irvine Technology Center.
[130466711]
Investigation including root cause analysis is in progress. A supplemental mdr will be filed as necessary in accordance with 21 cfr 803. 56 when additional reportable information becomes available. A product sample has been shipped; however, it has not been received for evaluation at the manufacturing site. The manufacturer internal reference number is: (b)(4).
Patient Sequence No: 1, Text Type: N, H10
[130466712]
A customer reported that the probe consistently stuck in the valved trocar during a procedure. The product was replaced and procedure completed with no patient harm.
Patient Sequence No: 1, Text Type: D, B5
Report Number | 2028159-2018-02607 |
MDR Report Key | 8163915 |
Report Source | OTHER,USER FACILITY |
Date Received | 2018-12-14 |
Date of Report | 2019-03-01 |
Date of Event | 2017-05-22 |
Date Mfgr Received | 2019-02-25 |
Date Added to Maude | 2018-12-14 |
Event Key | 0 |
Report Source Code | Manufacturer report |
Manufacturer Link | Y |
Number of Patients in Event | 0 |
Adverse Event Flag | 3 |
Product Problem Flag | 3 |
Reprocessed and Reused Flag | 3 |
Health Professional | 3 |
Initial Report to FDA | 3 |
Report to FDA | 3 |
Event Location | 3 |
Manufacturer Contact | MS. CINDY MILAM |
Manufacturer Street | 6201 SOUTH FREEWAY MAIL STOP AB2-6 |
Manufacturer City | FORT WORTH TX 76134 |
Manufacturer Country | US |
Manufacturer Postal | 76134 |
Manufacturer Phone | 8176152231 |
Manufacturer G1 | ALCON RESEARCH, LTD. - IRVINE TECHNOLOGY CENTER |
Manufacturer Street | 15800 ALTON PARKWAY |
Manufacturer City | IRVINE CA 92618 |
Manufacturer Country | US |
Manufacturer Postal Code | 92618 |
Single Use | 3 |
Previous Use Code | 3 |
Removal Correction Number | NA |
Event Type | 3 |
Type of Report | 3 |
Brand Name | EDGEPLUS VALVED ENTRY SYSTEM |
Generic Name | CANNULA, TROCAR, OPHTHALMIC |
Product Code | NGY |
Date Received | 2018-12-14 |
Returned To Mfg | 2019-01-07 |
Model Number | NA |
Catalog Number | 8065751585 |
Lot Number | ASKU |
Operator | HEALTH PROFESSIONAL |
Device Availability | R |
Device Age | DA |
Device Eval'ed by Mfgr | Y |
Device Sequence No | 1 |
Device Event Key | 0 |
Manufacturer | ALCON RESEARCH, LTD. - IRVINE TECHNOLOGY CENTER |
Manufacturer Address | 15800 ALTON PARKWAY IRVINE CA 92618 US 92618 |
Patient Number | Treatment | Outcome | Date |
---|---|---|---|
1 | 0 | 2018-12-14 |