BEUDAMED
    FDA Adverse Event Injury Summary report: N

    ACRYSOF RESTOR

    MDR report key: 1523805 · Received November 6, 2009

    Report

    Report Number
    1119421-2009-01058
    Event Type
    Injury
    Date Received
    November 6, 2009
    Date of Event
    June 30, 2009
    Report Date
    October 7, 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
    NY, 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 INFO WAS REQUESTED ON 10/13/2009, 10/19/2009, AND 10/26/2009 BY PHONE, FAX, AND MAIL. A COMPLETED QUESTIONNAIRE HAS NOT BEEN RECEIVED. THIS REPORT WAS MAILED TO FDA ON: 11/06/2009.

    Description of Event or Problem · 1

    A SURGICAL OFFICE MANAGER REPORTED SIX PTS WHO HAD AN INTRAOCULAR LENS (IOL) EXCHANGE PERFORMED. THIS PT HAD HIS IOL EXCHANGED DUE TO AN UNEXPECTED POSTOPERATIVE REFRACTION. ADDITIONAL INFO HAS BEEN REQUESTED. THERE ARE SEVEN MEDICAL DEVICE REPORTS ASSOCIATED WITH THIS EVENT. THIS REPORT IS FOR THE SIXTH PT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 ACRYSOF RESTOR INTRAOCULAR LENS MFK ALCON RESEARCH, LTD./HUNTINGTON SN6AD1 10875399

    Patients

    Seq Age Sex Outcome Treatment
    1 Required Intervention