FDA Adverse Event Other Summary report: N

ACRYSOF RESTOR

MDR report key: 1353613 · Received March 26, 2009

Report

Report Number
1119421-2009-00277
Event Type
Other
Date Received
March 26, 2009
Date of Event
February 1, 2009
Report Date
February 24, 2009
Manufacturer
ALCON RESEARCH, LTD./HUNTINGTON
Product Code
MFK
PMA / PMN Number
P040020
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
NJ, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THE PRODUCT WAS NOT RETURNED FOR ANALYSIS; DEVICE REMAINS IMPLANTED. PRODUCT HISTORY RECORDS COULD NOT BE REVIEWED BECAUSE THE REPORTING FACILITY DID NOT PROVIDE A LOT # OR ANY IDENTIFICATION TRACEABLE TO THE MFG DOCUMENTATION. ADDITIONAL INFO WAS REQUESTED ON 02/26/2009, 03/12/2009 ADM 03/19/2009 BY PHONE, FAX AND MAIL. A COMPLETED QUESTIONAIRE HAS NOT BEEN RECEIVED. THIS REPORT WAS MAILED TO FDA ON: 03/26/2009.

Description of Event or Problem · 1

A SURGEON REPORTED AN UNEXPECTED POSTOPERATIVE REFRACTION FOLLOWING INTRAOCULAR LENS (IOL) IMPLANT SURGERY. ADDITIONAL INFO HAS BEEN REQUESTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ACRYSOF RESTOR INTRAOCULAR LENS MFK ALCON RESEARCH, LTD./HUNTINGTON SN6AD3 NI

Patients

Seq Age Sex Outcome Treatment
1 57 YR Other