FDA Adverse Event Other Summary report: N

ACRYSOF RESTOR

MDR report key: 1624723 · Received March 5, 2010

Report

Report Number
1119421-2010-00238
Event Type
Other
Date Received
March 5, 2010
Date of Event
June 30, 2009
Report Date
February 5, 2010
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; THE DEVICE REMAINS IMPLANTED. 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 02/15/2010 AND 02/24/2010 BY PHONE, FAX, AND MAIL. A COMPLETED QUESTIONNAIRE WAS RECEIVED ON 02/24/2010. (B) (4). (B) (4). (B) (4).

Description of Event or Problem · 1

A TECHNICIAN REPORTED THAT A PT HAS CLOUDY VISION FOLLOWING BILATERAL INTRAOCULAR LENS (IOL) IMPLANT SURGERIES. IN A FOLLOW-UP, THE SURGEON REPORTED THE PT HAS A PRE-EXISTING MACULAR SCAR. THE EVENT HAS NOT RESOLVED FOR THE PT. IN THE SURGEON'S OPINION, THE DEVICE DID NOT CAUSE/CONTRIBUTE TO THE EVENT. THERE ARE TWO MEDICAL DEVICE REPORTS ASSOCIATED WITH THIS EVENT. THIS REPORT IS FOR THE LEFT EYE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ACRYSOF RESTOR INTRAOCULAR LENS MFK ALCON RESEARCH, LTD./HUNTINGTON SN6AD1 10904921

Patients

Seq Age Sex Outcome Treatment
1 53 YR Other VISCOELASTIC