FDA Adverse Event Malfunction Summary report: N

CATALYS SYSTEM

MDR report key: 11938252 · Received June 4, 2021

Report

Report Number
3006695864-2021-07828
Event Type
Malfunction
Date Received
June 4, 2021
Date of Event
May 12, 2021
Report Date
June 4, 2021
Manufacturer
AMO MANUFACTURING USA, LLC
Product Code
OOE
UDI-DI
05050474609792
PMA / PMN Number
K200056
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
WA, US
Reporter Occupation
003

Narratives

Additional Manufacturer Narrative · 1

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 MITIGATION'S 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-U LASER SYSTEM (S/N (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. BASED ON THE INVESTIGATION RESULTS THERE IS NO INDICATION OF A PRODUCT QUALITY DEFICIENCY. JOHNSON & JOHNSON SURGICAL VISION WILL CONTINUE TO MONITOR THIS TYPE OF COMPLAINTS. ALL PERTINENT INFORMATION AVAILABLE TO JOHNSON & JOHNSON SURGICAL VISION, INC HAS BEEN SUBMITTED.

Description of Event or Problem · 1

IT WAS REPORTED SUCTION WAS LOST WHEN SURGEON WAS TRYING TO PERFORM THE CAPSULORHEXIS DURING LASER TREATMENT. CUSTOMER DOES NOT KNOW IF LASER WAS ACTUALLY FIRING AT THE TIME. THERE WAS NO PATIENT INJURY REPORTED OR SURGICAL INTERVENTION NEEDED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
833718 CATALYS SYSTEM OPHTHALMIC FEMTOSECOND LASER OOE AMO MANUFACTURING USA, LLC CATALYS-U 05050474609792

Patients

Seq Age Sex Outcome Treatment
1 LIQUID OPTICS INTERFACE