FDA Adverse Event Injury Summary report: N

CATALYS SYSTEM

MDR report key: 11870234 · Received May 24, 2021

Report

Report Number
3006695864-2021-07714
Event Type
Injury
Date Received
May 24, 2021
Date of Event
March 21, 2021
Report Date
May 24, 2021
Manufacturer
AMO MANUFACTURING USA, LLC
Product Code
OOE
UDI-DI
05050474609792
PMA / PMN Number
K200056
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

WEIGHT, ETHNICITY: UNKNOWN, NOT PROVIDED. A RECORD REVIEW WAS PERFORMED. A PRODUCT DEFICIENCY REVIEW WAS PERFORMED AND THERE IS NO PRODUCT DEFICIENCY IDENTIFIED. A DOCUMENT, SERVICE HISTORY, AND TRENDING WAS REVIEWED. THERE IS NOT A RECOGNIZABLE ADVERSE TREND. THE RISKS AND MITIGATIONS ASSOCIATED WITH THE COMPLAINT ISSUE ARE IDENTIFIED IN EXISTING RISK DOCUMENTS AND NO NEW RISKS WERE IDENTIFIED AS PART OF THIS INVESTIGATION. A LABELING REVIEW WAS CONDUCTED; THE OPERATOR MANUAL FOR THE SYSTEM WAS REVIEWED AND FOUND TO INCLUDE ADEQUATE INSTRUCTIONS FOR USE, WARNINGS AND OPERATIONAL ERRORS. THE REVIEW OF THE DEVICE HISTORY RECORD (DHR) FOR CATALYS SYSTEM SERIAL (B)(4) SHOWED THAT THERE WERE NO ISSUES OR NON-CONFORMITIES. THE SYSTEM AND ITS COMPONENTS MET ALL SPECIFICATIONS PRIOR TO BEING RELEASED. MANUFACTURING HAS BEEN RULED OUT AS A POTENTIAL CAUSE FOR THE REPORTED ISSUE. BASED ON THE INVESTIGATION RESULTS, NO CORRECTIVE ACTION HAS BEEN ISSUED. ALL PERTINENT INFORMATION AVAILABLE TO JOHNSON & JOHNSON SURGICAL VISION, INC HAS BEEN SUBMITTED.

Description of Event or Problem · 1

A CATARACT PATIENT EXPERIENCED A POSTERIOR CAPSULE BREAK DURING SURGERY WHEN USING THE CATALYS LASER EQUIPMENT. IT WAS LEARNT THE CATARACT PATIENT HAD A PRIOR HISTORY OF VITRECTOMY PROCEDURE AND UNRELATED TO THE CATALYS SYSTEM. A JJSV APPLICATION SUPPORT MANAGER (ASM) REVIEWED THE CASE WITH THE SURGEON. THE JJSV ASM EXPLAINED TO THE SURGEON THAT TREATING A PATIENT WHO HAD PRIOR HISTORY OF VITRECTOMY HAS NOT BEEN STUDIED; THEREFORE, IT IS NOT RECOMMENDED TO TREAT THESE PATIENTS. THIS IS 1 OF 2 REPORTS. A SEPARATE REPORT WILL BE SUBMITTED FOR PATIENT #2 (REFERENCE REPORTING NO. 3006695864 -2021 -07707).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
765732 CATALYS SYSTEM OPHTHALMIC FEMTOSECOND LASER OOE AMO MANUFACTURING USA, LLC CATALYS-U 05050474609792

Patients

Seq Age Sex Outcome Treatment
1 Other