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 |