FDA Adverse Event Malfunction Summary report: N

SILICONE ULTRAVIOLET-ABSORBING POSTERIOR CHAMBER THREE PIECE FOLDABLE INTRAOCULA

MDR report key: 2438060 · Received January 16, 2012

Report

Report Number
2023826-2012-00037
Event Type
Malfunction
Date Received
January 16, 2012
Date of Event
December 13, 2011
Report Date
December 21, 2011
Manufacturer
STAAR SURGICAL CO.
Product Code
HQL
PMA / PMN Number
P900048
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
FL
Reporter Occupation
NURSE

Narratives

Additional Manufacturer Narrative · 1

(B)(4). RESULTS: VISUAL INSPECTION OF THE RETURNED PRODUCT FOUND PIECE OF OPTIC IS TORN OFF AND MISSING. THERE WAS EVIDENCE OF REDDISH RESIDUE ON LENS SURFACE. CONCLUSION: AN INVESTIGATION OF THE ROOT CAUSES OF LENS TEARS, SIMILAR TO THAT STATED IN THIS CLAIM, WERE ADDRESSED IN A CAPA OPENED IN (B)(4) 2005 (WHICH WAS SUBSEQUENTLY CLOSED). THE CAPA ADDRESSED DELIVERY SYSTEM ISSUES INCLUDING ALL STAGES OF MANUFACTURING OF THE INJECTORS AND CARTRIDGES. PROCESSES WERE REVIEWED AND REVISED AS OPPORTUNITIES FOR IMPROVEMENT WERE REVEALED. THE CAPA ALSO ADDRESSED HANDLING ERRORS. ALL INJECTOR/CARTRIDGE DIRECTIONS FOR USE (DFU) HAVE BEEN MODIFIED TO ADD FURTHER CLARIFICATIONS TO INSTRUCT THE USERS IN THE PROPER DELIVERY TECHNIQUES THAT ARE EFFECTIVE, AND MINIMIZE THE POTENTIAL FOR DAMAGING THE LENS. BASED ON THE COMPLAINT HISTORY AND THE EVALUATION OF THE RETURNED PRODUCT, POSSIBLE ROOT CAUSES FOR LENS TEARS INCLUDE BOTH DELIVERY SYSTEM ISSUES AND HANDLING ERRORS BY THE CUSTOMER. (B)(4).

Description of Event or Problem · 1

THE REPORTER STATED THE SURGEON INSERTED AN AQ2015A SILICONE ASPHERIC THREE PIECE LENS. LENS TORE DURING INSERTION IN THE EYE. LENS WAS REMOVED WITH NO PATIENT INJURY. BACKUP LENS WAS IMPLANTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 SILICONE ULTRAVIOLET-ABSORBING POSTERIOR CHAMBER THREE PIECE FOLDABLE INTRAOCULA INTRAOCULAR LENS HQL STAAR SURGICAL CO. AQ2015A NA

Patients

Seq Age Sex Outcome Treatment
1 CARTRIDGE MODEL - AQ CARTRIDGE-FP - LOT # - UNK| INJECTOR MODEL - MSI-TM - LOT # - UNK