FDA Adverse Event Injury Summary report: N

SILICONE ADVANCED OPTIC LENS

MDR report key: 1940310 · Received December 17, 2010

Report

Report Number
1119279-2010-00121
Event Type
Injury
Date Received
December 17, 2010
Date of Event
November 18, 2010
Report Date
November 18, 2010
Manufacturer
BAUSCH & LOMB
Product Code
HQL
PMA / PMN Number
P910061
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
CA
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

THE DEVICE HISTORY RECORDS WERE REVIEWED AND THERE WERE NO DISCREPANCIES OR UNUSUAL FINDING THAT RELATE TO THE REPORTED ISSUE. (B)(4).

Description of Event or Problem · 1

THE SURGEON REPORTS PERFORMING CATARACT SURGERY WITH ATTEMPTED IMPLANTATION OF THE SILICONE (B)(4) INTRAOCULAR LENS (IOL) USING THE EZ-28 DELIVERY DEVICE SYSTEM. INTRAOPERATIVELY, THE SURGEON WAS UNABLE TO PROPERLY POSITION THE IOL IN THE CAPSULAR BAG. THE IOL WAS REMOVED, A VITRECTOMY WAS PERFORMED AND AN ANTERIOR CHAMBER IOL WAS IMPLANTED SUCCESSFULLY. ADDITIONAL INFORMATION HAS BEEN REQUESTED. REFERENCE MDR #1119279-2010-000122.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 SILICONE ADVANCED OPTIC LENS INTRAOCULAR LENS HQL BAUSCH & LOMB LI61AOR 4012313

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention EZ-28 DELIVERY DEVICE (B+L)