FDA Adverse Event Injury Summary report: N

ACRYSOF RESTOR

MDR report key: 2894781 · Received December 20, 2012

Report

Report Number
1119421-2012-01621
Event Type
Injury
Date Received
December 20, 2012
Date of Event
September 1, 2012
Report Date
December 4, 2012
Manufacturer
ALCON RESEARCH, LTD./HUNTINGTON
Product Code
HQL
PMA / PMN Number
P040020
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
PA, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THE PRODUCT WAS NOT RETURNED FOR ANALYSIS. RESULTS FROM THE PRODUCT HISTORY RECORD REVIEW INDICATED THE PRODUCT MET RELEASE CRITERIA. THE PRODUCT INVESTIGATION COULD NOT IDENTIFY A ROOT CAUSE. THERE HAVE BEEN NO OTHER COMPLAINTS REPORTED IN THE LOT NUMBER. ATTEMPTS HAVE BEEN MADE TO OBTAIN ADDITIONAL INFO. A COMPLETED QUESTIONNAIRE HAS NOT BEEN RECEIVED. (B)(4).

Description of Event or Problem · 1

A SURGEON REPORTED AN INTRAOCULAR LENS (IOL) WAS EXCHANGED DUE TO AN UNEXPECTED POSTOPERATIVE REFRACTION. THE LENS WAS EXCHANGED FOR THE SAME MODEL, DIFFERENT POWER LENS. ADDITIONAL INFO HAS BEEN REQUESTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ACRYSOF RESTOR INTRAOCULAR LENS HQL ALCON RESEARCH, LTD./HUNTINGTON SN6AD1 11078329

Patients

Seq Age Sex Outcome Treatment
1 Other