FDA Adverse Event Injury Summary report: N

ALLEGRETTO WAVE EYE-Q

MDR report key: 2052563 · Received April 8, 2011

Report

Report Number
3003288808-2011-00062
Event Type
Injury
Date Received
April 8, 2011
Date of Event
February 24, 2011
Report Date
March 11, 2011
Manufacturer
WAVELIGHT GMBH
Product Code
LZS
PMA / PMN Number
P030008/PO:
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
GM
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

DEVICE WAS VERIFIED BY FIELD SERVICE ENGINEER AND FOUND TO BE OPERATING TO SPECIFICATIONS. CASE LOGFILE REVIEW DID NOT SHOW ANY SYSTEM ISSUES. BASED ON THE RESULTS OF THE INVESTIGATION, THE DEVICE WAS FOUND TO BE OPERATING TO SPECIFICATIONS. ROOT CAUSE FOR THE REPORTED ISSUE COULD NOT BE DETERMINED. (B)(4).

Description of Event or Problem · 1

SURGEON REPORTED POST OPERATIVE CENTRAL ISLANDS AND MYOPIA, POST LASIK SURGERY. PT INFORMATION REC'D SHOWS PT EXPERIENCED DECREASE IN BCVA AT ONE DAY POST OP, AND SLIGHT OVER CORRECTION AT ELEVEN DAYS POST OP, FOR THE RIGHT EYE. SURGEON MENTIONED THAT THE CASE MAY NEED AN ADDITIONAL TREATMENT IN THE LONG TERM. LEFT EYE OF THE SAME PT IS REPORTED UNDER MANUFACTURER'S REPORT #3003288808-2011-00069.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ALLEGRETTO WAVE EYE-Q OPHTHALMIC EXCIMER LASER SYSTEM LZS WAVELIGHT GMBH 8065990631 NA

Patients

Seq Age Sex Outcome Treatment
1 24 YR Other