FDA Adverse Event Injury Summary report: N

INTACS CORNEAL IMPLANTS

MDR report key: 2473785 · Received March 15, 2012

Report

Report Number
2953726-2012-00001
Event Type
Injury
Date Received
March 15, 2012
Date of Event
January 6, 2012
Report Date
February 28, 2012
Manufacturer
ADDITION TECHNOLOGY
Product Code
LQE
PMA / PMN Number
H040002
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
WI, US
Reporter Occupation
NURSE

Narratives

Additional Manufacturer Narrative · 1

(B)(4).

Description of Event or Problem · 1

INTACS WERE IMPLANTED INTO THE CORNEA BY USE OF THE INTRALASE LASER TECHNIQUE. AT POST-OP, CORNEAL EDEMA WAS EVIDENT SO INTACS WERE REMOVED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 INTACS CORNEAL IMPLANTS CORNEAL IMPLANTS LQE ADDITION TECHNOLOGY ICI-450-150 B11H1066

Patients

Seq Age Sex Outcome Treatment
1 UNK Required Intervention