FDA Adverse Event Other Summary report: N

ACRYSOF RESTOR

MDR report key: 1565458 · Received December 18, 2009

Report

Report Number
1119421-2009-01187
Event Type
Other
Date Received
December 18, 2009
Date of Event
November 1, 2009
Report Date
November 18, 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
IL, 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 REPORTER DID NOT PROVIDE A LOT NUMBER OR ANY IDENTIFICATION TRACEABLE TO THE MANUFACTURING DOCUMENTATION. ADDITIONAL INFORMATION WAS REQUESTED ON 11/18/2009, 11/19/2009, 12/03/2009, AND 12/04/2009 BY PHONE, FAX, AND MAIL. A COMPLETED QUESTIONNAIRE HAS NOT BEEN RECEIVED. (B) (4). (B) (4). (B) (4).

Description of Event or Problem · 1

A SURGEON REPORTED A PATIENT WITH AN UNEXPECTED POSTOPERATIVE REFRACTION AND DIFFICULTY READING FOLLOWING INTRAOCULAR LENS (IOL) IMPLANT SURGERY. ADDITIONAL INFORMATION HAS BEEN REQUESTED.

Devices

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

Patients

Seq Age Sex Outcome Treatment
1 53 YR Other