FDA Adverse Event Malfunction Summary report: N

ISERT ASPHERIC INTRAOCULAR LENS

MDR report key: 2062971 · Received March 21, 2011

Report

Report Number
3006723646-2011-00089
Event Type
Malfunction
Date Received
March 21, 2011
Date of Event
March 3, 2011
Report Date
March 21, 2011
Manufacturer
HOYA SURGICAL OPTICS, INC.
Product Code
HQL
PMA / PMN Number
P080004
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
TN, US
Reporter Occupation
PHYSICIAN

Narratives

Description of Event or Problem · 1

LENS WAS EXPLANTED BECAUSE A HAPTIC BROKE DURING LENS INSERTION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ISERT ASPHERIC INTRAOCULAR LENS HQL HOYA SURGICAL OPTICS, INC. PY-60AD

Patients

Seq Age Sex Outcome Treatment
1 68 YR Required Intervention