255
Report
- Report Number
- 3006723646-2023-00032
- Event Type
- Malfunction
- Date Received
- March 7, 2023
- Date of Event
- February 7, 2023
- Report Date
- May 11, 2023
- Manufacturer
- HOYA SURGICAL OPTICS, INC.
- Product Code
- HQL
- PMA / PMN Number
- P080004
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- JA
- Reporter Occupation
- OTHER
- Health Professional
- N
Narratives
THIS FOLLOW-UP #1 EMDR IS BEING SUBMITTED TO FDA FOR A REPORTABLE EVENT THAT OCCURRED OUTSIDE OF THE USA. THE REPORT INCLUDES CORRECTED INFORMATION AND ADDITIONAL INFORMATION NOT AVAILABLE/INCLUDED IN THE INITIAL REPORT. THE PRODUCT WAS RETURNED TO THE MANUFACTURER. THE INVESTIGATION WAS CONDUCTED, WITH THE METHODS AND RESULTS AS NOTED BELOW. NO ABNORMALITIES WERE FOUND IN PRODUCTION AND INSPECTION RECORDS OF THE PRODUCT. (SERIAL NO.: (B)(6) ; MODEL: 255) THE DYE TEST RESULT SHOWED THE INJECTOR TIP WAS PROPERLY COATED. PROPER COATING ALLOWS THE LENS TO ADVANCE. WE COULD RELEASE A RE-INSTALLED IOL FROM THE RETURNED INJECTOR WITHOUT ANY PROBLEMS. THE EXACT ROOT CAUSE OF THE EVENT WAS NOT DETERMINED. HOWEVER, BASED ON AVAILABLE INFORMATION, WE BELIEVE THIS EVENT WAS NOT CAUSED BY OUR PRODUCT QUALITY. CAPA-22-0009 HAS BEEN INITIATED FOR "DAMAGED HAPTIC" COMPLAINTS.
THIS INITIAL REPORT IS BEING SUBMITTED TO FDA FOR A REPORTABLE EVENT THAT OCCURRED OUTSIDE THE USA. HAPTIC DAMAGE IS INDICATED AS A POTENTIAL MALFUNCTION RELATED TO THE IOL, AS COVERED UNDER THE WARNINGS SECTION OF THE PRODUCT'S INSTRUCTIONS FOR USE (IFU). MANUFACTURER'S CODES FOR: TYPE OF INVESTIGATION, FINDINGS, AND CONCLUSION ARE PENDING DEVICE RETURN AND COMPLETION OF PRODUCT INVESTIGATION. ONCE THE PRODUCT INVESTIGATION IS COMPLETED, A FOLLOW-UP REPORT WILL BE SUBMITTED TO FDA WHICH WILL INCLUDE THE MANUFACTURER'S CODES FOR TYPE OF INVESTIGATION, FINDINGS, AND CONCLUSION.
DAMAGED HAPTIC AFTER IMPLANTATION. THE DOCTOR FOUND TIP OF THE TRAILING HAPTIC WAS SEPARATED JUST AFTER IMPLANTATION. THE IOL WAS NOT EXPLANTED SINCE IT WAS STABLE IN THE BAG. PATIENT IMPACT: NOT HEALTH CONSEQUENCES OR IMPACT.
DAMAGED HAPTIC AFTER IMPLANTATION. THE DOCTOR FOUND TIP OF THE TRAILING HAPTIC WAS SEPARATED JUST AFTER IMPLANTATION. THE IOL WAS NOT EXPLANTED SINCE IT WAS STABLE IN THE BAG. PATIENT IMPACT: NOT HEALTH CONSEQUENCES OR IMPACT.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 63697 | 255 | INTRAOCULAR LENS | HQL | HOYA SURGICAL OPTICS, INC. | 255 (+ 13.00 D) |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | Unknown | Other |