FDA Adverse Event
Injury
Summary report: N
ENVISTA INTRAOCULAR LENS
MDR report key: 2855653
·
Received November 30, 2012
Report
- Report Number
- 1119279-2012-00296
- Event Type
- Injury
- Date Received
- November 30, 2012
- Report Date
- October 31, 2012
- Manufacturer
- BAUSCH + LOMB
- Product Code
- HQL
- PMA / PMN Number
- P910056
- Adverse Event
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- FR
- Reporter Occupation
- OTHER
Narratives
Additional Manufacturer Narrative · 1
THE LOT HISTORY RECORD WAS REVIEWED FOR THE LENS AND THERE WERE NO NONCONFORMITIES OR ANOMALIES RELATED TO THIS COMPLAINT. THE PRODUCT WAS DEEMED ACCEPTABLE FOR RELEASE. THE DEVICE HAS BEEN RECEIVED FOR EVALUATION. THE EVENT INVESTIGATION IS UNDERWAY. A SUPPLEMENTAL REPORT WILL BE SUBMITTED UPON COMPLETION OF THE INVESTIGATION.
Description of Event or Problem · 1
IT WAS REPORTED THAT AFTER THE LENS WAS INSERTED INTO THE CAPSULAR BAG THE LENS HAPTIC RIPPED DURING UNFOLDING. THE INCISION WAS ENLARGED TO REMOVE AND REPLACE THE LENS WITH ANOTHER LENS. A STITCH WAS PLACED IN THE INCISION. THE LENS THAT WAS USED DURING THIS EVENT IS REPORTED UNDER 111927-2012-00297.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1 | ENVISTA INTRAOCULAR LENS | HQL; INTRAOCULAR LENS | HQL | BAUSCH + LOMB | MX60 | 3218421 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | ACCUJECT DELIVERY DEVICE |