FDA Adverse Event Injury Summary report: N

CLAREON VIVITY TORIC EXTENDED VISION UV ABSORBING IOL

MDR report key: 17757086 · Received September 15, 2023

Report

Report Number
9612169-2023-00649
Event Type
Injury
Date Received
September 15, 2023
Report Date
September 15, 2023
Manufacturer
ALCON LABORATORIES IRELAND LTD.
Product Code
MJP
UDI-DI
00380652455213
PMA / PMN Number
P190018
Removal / Correction Number
NA
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
AL, US
Reporter Occupation
003

Narratives

Additional Manufacturer Narrative · 0

A SAMPLE DEVICE WAS NOT RETURNED FOR ANALYSIS. COMPLAINT HISTORY AND PRODUCT HISTORY RECORDS WERE REVIEWED AND DOCUMENTATION INDICATED THE PRODUCT MET RELEASE CRITERIA. ROOT CAUSE HAS NOT BEEN IDENTIFIED. THE MANUFACTURER INTERNAL REFERENCE NUMBER IS: (B)(4).

Description of Event or Problem · 0

A NON HEALTHCARE PROFESSIONAL REPORTED THAT FOLLOWING AN INTRAOCULAR LENS (IOL) IMPLANT PROCEDURE, THE PATIENT EXPERIENCED DECREASED VISUAL ACUITY AT DISTANCE. THE PATIENT WAS UNABLE TO PERFORM DAILY TASK. CLINICAL REASON FOR EXPLANT WAS MENTIONED AS IOL ROTATION AND ORIENTATION OF ASTIGMATISM CORRECTION WAS NOT CORRECT. ADDITIONAL INFORMATION HAS BEEN REQUESTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
290367 CLAREON VIVITY TORIC EXTENDED VISION UV ABSORBING IOL LENS, INTRAOCULAR, TORIC OPTICS MJP ALCON LABORATORIES IRELAND LTD. CCWET3 25352499 00380652455213

Patients

Seq Age Sex Outcome Treatment
1 Male Other