255
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
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.
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 |