BEUDAMED
    FDA Adverse Event Injury Summary report: N

    LIGHT ADJUSTABLE LENS (LAL)

    MDR report key: 12969830 · Received December 9, 2021

    Report

    Report Number
    3012712027-2021-00082
    Event Type
    Injury
    Date Received
    December 9, 2021
    Date of Event
    July 7, 2021
    Report Date
    December 8, 2021
    Manufacturer
    RXSIGHT, INC.
    Product Code
    PZK
    UDI-DI
    00818806020234
    PMA / PMN Number
    P160055
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    AZ, US
    Reporter Occupation
    PHYSICIAN
    Health Professional
    Yes

    Narratives

    Additional Manufacturer Narrative · 0

    SITE REPORTED THE LIGHT ADJUSTABLE LENS WAS EXPLANTED FROM THE PATIENT'S EYE AS THE PATIENT DID NOT RETURN FOR ANY LIGHT ADJUSTMENT TREATMENTS. ANOTHER LAL WAS IMPLANTED DURING THE EXCHANGE ON (B)(6) 2021. RXSIGHT'S FIRST AWARENESS OF THE EVENT OCCURRED ON (B)(6) 2021. DEVICE HISTORY RECORD FOR THE LENS WAS REVIEWED. NO ISSUES WERE NOTED. THE LENS IS IN THE PROCESS OF BEING RETURNED FOR EVALUATION.

    Additional Manufacturer Narrative · 0

    SITE REPORTED THE LIGHT ADJUSTABLE LENS WAS EXPLANTED FROM THE PATIENT'S EYE AS THE PATIENT DID NOT RETURN FOR ANY LIGHT ADJUSTMENT TREATMENTS. ANOTHER LAL WAS IMPLANTED DURING THE EXCHANGE ON (B)(6) 2021. RXSIGHT'S FIRST AWARENESS OF THE EVENT OCCURRED ON 12/1/2021. THE EXPLANTED LENS WAS RETURNED FOR EVALUATION. VISUAL AND OPTICAL TESTING VERIFIED THE PRESENCE OF A ZONE NEAR THE CENTER OF THE LENS. THE PRESENCE OF THE ZONE IS INDICATIVE OF LENS EXPOSURE TO AMBIENT UV LIGHT.

    Description of Event or Problem · 0

    SITE REPORTED THE LIGHT ADJUSTABLE LENS WAS EXPLANTED FROM THE PATIENT'S EYE AS THE PATIENT DID NOT RETURN FOR ANY LIGHT ADJUSTMENT TREATMENTS. ANOTHER LAL WAS IMPLANTED DURING THE EXCHANGE ON (B)(6) 2021. RXSIGHT'S FIRST AWARENESS OF THE EVENT OCCURRED ON (B)(6) 2021.

    Description of Event or Problem · 0

    SITE REPORTED THE LIGHT ADJUSTABLE LENS WAS EXPLANTED FROM THE PATIENT'S EYE AS THE PATIENT DID NOT RETURN FOR ANY LIGHT ADJUSTMENT TREATMENTS. ANOTHER LAL WAS IMPLANTED DURING THE EXCHANGE ON (B)(6) 2021. RXSIGHT'S FIRST AWARENESS OF THE EVENT OCCURRED ON 12/1/2021.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1867481 LIGHT ADJUSTABLE LENS (LAL) LIGHT ADJUSTABLE LENS PZK RXSIGHT, INC. 60005 L02-001398 00818806020234

    Patients

    Seq Age Sex Outcome Treatment
    1 Female Required Intervention