FDA Adverse Event Injury Summary report: N

ALLEGRETTO WAVE EYE-Q

MDR report key: 2912973 · Received January 9, 2013

Report

Report Number
3003288808-2013-00003
Event Type
Injury
Date Received
January 9, 2013
Date of Event
December 10, 2012
Report Date
December 10, 2012
Manufacturer
WAVELIGHT GMBH
Product Code
LZS
PMA / PMN Number
P030008
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
MN, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

INVESTIGATION, INCLUDING ROOT CAUSE ANALYSIS, IS IN PROGRESS. A SUPPLEMENTAL MDR WILL BE FILED AS NECESSARY IN ACCORDANCE WITH 21 CFR 803.56 WHEN ADDITIONAL REPORTABLE INFORMATION BECOMES AVAILABLE. (B)(4).

Description of Event or Problem · 1

AN OPTOMETRIST REPORTED THAT A PATIENT WHO UNDERWENT BILATERAL LASIK WAS DIAGNOSED WITH TRACE DLK (DIFFUSE LAMELLAR KERATITIS) IN BOTH EYES ON THE SECOND POST-OP DAY. THE STEROID DROPS WERE INCREASED, WHICH RESOLVED THE DLK, AND THE UNCORRECTED VA IS 20/20.. THIS REPORT CONCERNS THE PATIENT'S RIGHT EYE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
12459 ALLEGRETTO WAVE EYE-Q OPHTHALMIC EXCIMER LASER SYSTEM LZS WAVELIGHT GMBH 8065990601 NA

Patients

Seq Age Sex Outcome Treatment
1 28 YR Required Intervention INTRALASE