FDA Adverse Event Injury Summary report: N

CRYSTALSERT CRYSTALENS DELIVERY SYSTEM

MDR report key: 2926304 · Received January 16, 2013

Report

Report Number
2031924-2013-00010
Event Type
Injury
Date Received
January 16, 2013
Date of Event
November 27, 2012
Report Date
December 17, 2012
Manufacturer
BAUSCH + LOMB
Product Code
MSS
PMA / PMN Number
K082944
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
TN, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

INVESTIGATION OF THIS EVENT IS IN PROGRESS. A SUPPLEMENTAL REPORT WILL BE SUBMITTED UPON COMPLETION OF THE INVESTIGATION.

Description of Event or Problem · 1

IT WAS REPORTED THAT DURING LENS IMPLANT, THE HAPTIC TORE THROUGH THE CAPSULAR BAG. THE LENS WAS REMOVED INTRAOPERATIVELY AND A VITRECTOMY WAS PERFORMED. THE PATIENT DEVELOPED CHOROIDAL HEMORRHAGING. THE SURGEON DECIDED TO LEAVE THE EYE APHAKIC AND THE PATIENT WAS REFERRED TO RETINA SPECIALIST FOR FURTHER EVALUATION. THE PATIENT'S CURRENT PROGNOSIS AND TREATMENT INCLUDE WEARING APHAKIC CONTACT LENS +12.00 PROCLEAR WITH OVER REFRACTION OF +2.00 TO 20/25. THIS EVENT REFERS TO THE PATIENT'S LEFT EYE. REFERENCE MDR # 2031924-2013-00009 FOR THE INTRAOCULAR LENS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
24808 CRYSTALSERT CRYSTALENS DELIVERY SYSTEM MSS/IOL INSERTER/INJECTOR MSS BAUSCH + LOMB CI-28

Patients

Seq Age Sex Outcome Treatment
1 75 YR Other CRYSTALENS ACCOMMODATING IOL