FDA Adverse Event Other Summary report: N

SILICONE ULTRAVIOLET-ABSORBING POSTERIOR CHAMBER THREE PIECE FOLDABLE INTRAOCULA

MDR report key: 1047863 · Received May 8, 2008

Report

Report Number
2023826-2008-00653
Event Type
Other
Date Received
May 8, 2008
Date of Event
April 10, 2008
Report Date
April 15, 2008
Manufacturer
STAAR SURGICAL CO.
Product Code
HQL
PMA / PMN Number
P900048
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
NURSE

Narratives

Description of Event or Problem · 1

THE REPORTER STATED THE HAPTIC OF AN AQ2010V SILICONE THREE PIECE LENS WAS TORN DURING LOADING BUT WAS NOT NOTICED UNTIL THE SURGEON HAD INSERTED THE LENS INTO THE PATIENT'S EYE. LENS WAS REMOVED WITH NO PT INJURY AND ANOTHER SILICONE THREE PIECE LENS WAS INSERTED. THIS LENS ALSO TORE - SEE MFR REPORT # 2023826-2008-00652. A THIRD SILICONE THREE PIECE LENS WAS IMPLANTED WITH NO PROBLEM. THE REPORTER STATED THE CAUSE OF THE TORN LENS MAY HAVE BEEN DUE TO A LOADING ERROR.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 SILICONE ULTRAVIOLET-ABSORBING POSTERIOR CHAMBER THREE PIECE FOLDABLE INTRAOCULA INTRAOCULAR LENS HQL STAAR SURGICAL CO. AQ2010V NA

Patients

Seq Age Sex Outcome Treatment
1 CARTRIDGE MODEL AQ CARTRIDGE-FP - LOT NUMBER UNK| INJECTOR MODEL MSI-TM - LOT NUMBER UNK