FDA Adverse Event Injury Summary report: N

VISIAN ICL (IMPLANTABLE COLLAMER LENS)

MDR report key: 2926140 · Received January 16, 2013

Report

Report Number
2023826-2013-00061
Event Type
Injury
Date Received
January 16, 2013
Report Date
December 17, 2012
Manufacturer
STAAR SURGICAL COMPANY
Product Code
MTA
PMA / PMN Number
P030016
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

(B)(4). METHOD: LENS WORK ORDER SEARCH. RESULTS: A LENS WORK ORDER SEARCH WAS PERFORMED AND NO SIMILAR COMPLAINTS WERE FOUND WITHIN THE WORK ORDER. CONCLUSIONS: BASED ON THE COMPLAINT HISTORY AND WORK ORDER SEARCH, A SPECIFIC ROOT CAUSE OF THE EVENT COULD NOT BE DETERMINED. (B)(4).

Description of Event or Problem · 1

IT WAS REPORTED PT HAD A MICL 12.6MM IMPLANTABLE COLLAMER LENS IMPLANTED IN THE LEFT EYE ON (B)(6) 2007. AS PART OF THE POST MARKET STUDY, THE PT REPORTED DOCTOR PRESCRIBED EYE DROPS FOR HIGH PRESSURE OR GLAUCOMA. THE ICL REMAINS IMPLANTED. SEE MDR # 2023826-2013-00062 FOR RIGHT EYE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
24651 VISIAN ICL (IMPLANTABLE COLLAMER LENS) INTRAOCULAR LENS MTA STAAR SURGICAL COMPANY MICL12.6 NA

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention