FDA Adverse Event Injury Summary report: N

ACRYSOF

MDR report key: 1253140 · Received December 5, 2008

Report

Report Number
1119421-2008-00987
Event Type
Injury
Date Received
December 5, 2008
Date of Event
November 15, 2006
Report Date
November 6, 2008
Manufacturer
ALCON RESEARCH, LTD. /HUNTINGTON
Product Code
HQL
PMA / PMN Number
P930014
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
IL, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THE PRODUCT WAS NOT RETURNED FOR ANALYSIS. RESULTS FROM THE PRODUCT HISTORY RECORD REVIEW INDICATED THE PRODUCT MET RELEASE CRITERIA. THERE HAVE BEEN NO OTHER COMPLAINTS REPORTED IN THE LOT NUMBER. ADDITIONAL INFORMATION WAS REQUESTED ON 11/07/2008, 11/11/2008, 11/21/2008, AND 11/25/2008 BY PHONE, FAX, AND MAIL. A COMPLETED QUESTIONNAIRE WAS RECEIVED ON 12/01/2008.

Description of Event or Problem · 1

A SURGEON REPORTED THAT ONE WEEK FOLLOWING AN INTRAOCULAR LENS (IOL) IMPLANT SURGERY, THE PATIENT CHANGED HER MIND AND WANTED ANOTHER MODEL LENS. THE LENS WAS EXCHANGED FOR A DIFFERENT MODEL. THE ORIGINAL SURGERY AND LENS EXCHANGE WERE DONE IN 2006.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ACRYSOF INTRAOCULAR LENS HQL ALCON RESEARCH, LTD. /HUNTINGTON SN60WF 110048

Patients

Seq Age Sex Outcome Treatment
1 65 YR Required Intervention