FDA Adverse Event Other Summary report: N

SILICONE ULTRAVIOLET-ABSORBING POSTERIOR CHAMBER SINGLE PIECE FOLDABLE INTRAOCUL

MDR report key: 1034594 · Received April 24, 2008

Report

Report Number
2023826-2008-00579
Event Type
Other
Date Received
April 24, 2008
Date of Event
April 1, 2008
Report Date
April 2, 2008
Manufacturer
STAAR SURGICAL CO.
Product Code
HQL
PMA / PMN Number
P880091
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
FL, US
Reporter Occupation
NURSE

Narratives

Additional Manufacturer Narrative · 1

.

Description of Event or Problem · 1

THE RPTR STATED THE SURGEON INSERTED AN AA4203TL TORIC SILICONE SINGLE PIECE LENS AND THE LENS TORE. THE LENS WAS REMOVED WITH NO PT INJURY, NO ENLARGED INCISION OR SUTURES. ANOTHER SAME TYPE LENS WAS INSERTED, BUT THIS LENS ALSO TORE - SEE MFR REPORT #: 2023826-2008-00578. A THIRD LENS WAS IMPLANTED WITH NO PROBLEM. THE RPTR STATED THE CAUSE OF THE TORN LENS WAS DUE TO THE INJECTOR HAVING BEEN USED TOO MANY TIMES.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 SILICONE ULTRAVIOLET-ABSORBING POSTERIOR CHAMBER SINGLE PIECE FOLDABLE INTRAOCUL INTRAOCULAR LENS HQL STAAR SURGICAL CO. AA4203TL NA

Patients

Seq Age Sex Outcome Treatment
1 CARTRIDGE MODEL MTC - 60C FP -LOT # UNK| INJECTOR MODEL MSI-PR - LOT # UNK