FDA Adverse Event Injury Summary report: N

ALLEGRETTO WAVE EYE-Q

MDR report key: 2980638 · Received February 21, 2013

Report

Report Number
3003288808-2013-00063
Event Type
Injury
Date Received
February 21, 2013
Date of Event
January 28, 2013
Report Date
January 28, 2013
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 INFO BECOMES AVAILABLE. (B)(4).

Description of Event or Problem · 1

AN OPTOMETRIST REPORTED THAT A PT WHO HAD UNDERGONE BILATERAL LASIK WAS DIAGNOSED WITH TRACE DLK (DIFFUSE LAMELLAR KERATITIS) IN BOTH EYES ON THE SECOND POST-OP DAY. THE STEROID DROPS WERE INCREASED, AND THE DLK HAS CLEARED. THIS REPORT CONCERNS THE PT'S LEFT EYE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
75247 ALLEGRETTO WAVE EYE-Q OPHTHALMIC EXCIMER LASER SYSTEM LZS WAVELIGHT GMBH 8065990601 NA

Patients

Seq Age Sex Outcome Treatment
1 29 YR Required Intervention INTRALASE