FDA Adverse Event Injury Summary report: N

255

MDR report key: 17015302 · Received May 26, 2023

Report

Report Number
3006723646-2023-00046
Event Type
Injury
Date Received
May 26, 2023
Date of Event
February 21, 2023
Report Date
May 7, 2023
Manufacturer
HOYA SURGICAL OPTICS, INC.
Product Code
HQL
PMA / PMN Number
P080004
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
JA
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 0

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). PORTIONS OF THE PRODUCT WERE RETURNED TO THE MANUFACTURER. THE INVESTIGATION WAS CONDUCTED, WITH THE METHODS AND RESULTS AS NOTED BELOW. APPEARANCE CHECK RESULT WAS CONSISTENT TO REPORTED INFORMATION. THE IOL WAS EJECTED FROM THE INJECTOR. THE TRAILING HAPTIC WAS DAMAGED AT THE TIP AND REMAINED INSIDE THE INJECTOR. 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.

Description of Event or Problem · 0

DAMAGED HAPTIC AFTER IMPLANTATION. THE DOCTOR NOTICED THE TRAILING HAPTIC WAS SEPARATED AND REMAINED IN THE INJECTOR JUST AFTER IMPLANTATION. THE IOL WAS NOT EXPLANTED SINCE IT WAS STABLE IN THE EYE. PATIENT IMPACT: NO HEALTH CONSEQUENCES OR IMPACT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1609268 255 INTRAOCULAR LENS HQL HOYA SURGICAL OPTICS, INC. 255 (+ 20.50 D)

Patients

Seq Age Sex Outcome Treatment
1 Unknown Required Intervention