FDA Adverse Event Injury Summary report: N

WAVELIGHT EX500 EXCIMER LASER

MDR report key: 10367090 · Received August 5, 2020

Report

Report Number
3003288808-2020-00457
Event Type
Injury
Date Received
August 5, 2020
Date of Event
July 7, 2020
Report Date
August 20, 2020
Manufacturer
WAVELIGHT GMBH
Product Code
LZS
PMA / PMN Number
P020050
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
RS
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 0

BASED ON INFORMATION RECEIVED FOLLOWING SUBMISSION OF THE INITIAL REPORT, THIS EVENT DOES NOT MEET CRITERIA FOR REPORTING AS A SERIOUS INJURY. THE MANUFACTURER INTERNAL REFERENCE NUMBER IS: (B)(4).

Description of Event or Problem · 0

ADDITIONAL INFORMATION RECEIVED REPORTED THE CLINIC USED A MICROKERATOME WITH REUSABLE RINGS AND DISPOSABLE BLADES. PRIOR TO THE REPORTED EVENTS, DISPOSABLE RINGS AND BLADES WERE ROUTINELY USED. SINCE DISCONTINUING USE OF THE REUSABLE RINGS, THERE HAVE NOT BEEN ANY ADDITIONAL CASES OF CORNEAL OPACITY. THE EXCIMER DEVICE WAS ALSO FOUND TO BE WORKING AS INTENDED AND WITHIN SPECIFICATIONS.

Additional Manufacturer Narrative · 1

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. THE MANUFACTURER INTERNAL REFERENCE NUMBER IS: (B)(4).

Description of Event or Problem · 1

A DOCTOR REPORTED A PATIENT WITH CORNEAL OPACITY IN THE RIGHT EYE THREE DAYS POST LASIK. FOR THE TREATMENT OF OPACITY, THE PATIENT WAS PRESCRIBED AN ANTIBIOTIC DROP, TOPICAL STEROID AND MOISTURIZING DROPS. ADDITIONAL SURGICAL INTERVENTIONS WERE NOT PERFORMED. ADDITIONAL INFORMATION RECEIVED NOTED THE OPACITY IS IMPROVING. THERE ARE MULTIPLE RELATED REPORTS FOR THIS EVENT. THIS REPORT ADDRESSES THE PATIENT INITIALS GAE'S RIGHT EYE, AND ADDITIONAL MANUFACTURER REPORTS WILL BE FILED FOR THE OTHER PATIENTS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
831985 WAVELIGHT EX500 EXCIMER LASER OPHTHALMIC EXCIMER LASER SYSTEM LZS WAVELIGHT GMBH NA NA

Patients

Seq Age Sex Outcome Treatment
1 26 YR Required Intervention