FDA Adverse Event Injury Summary report: N

IOLMASTER 500

MDR report key: 3040134 · Received April 3, 2013

Report

Report Number
9615030-2013-00006
Event Type
Injury
Date Received
April 3, 2013
Report Date
March 4, 2013
Manufacturer
CARL ZEISS MEDITEC AG (JENA SITE)
Product Code
HJO
PMA / PMN Number
K101182
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
AR, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

A FIELD SERVICE ENGINEER PERFORMED AN ON-SITE INSPECTION OF THE IOLMASTER 500. THE INSTRUMENT WAS FOUND TO BE WORKING WITHIN SPECIFICATIONS FOR THOSE PARAMETERS THAT AFFECT THE IOL CALCULATION, INCLUDING AXIAL LENGTH, KERATOMETRY, WHITE-TO-WHITE AND ANTERIOR CHAMBER DEPTH MEASUREMENTS. THE INSTRUMENT WAS FOUND TO BE OUT OF SPECIFICATION FOR SLED SPEED AND AXIAL LENGTH END LIMITS. THE MEASUREMENT HEAD WAS REPLACED TO ADDRESS THE END LIMITS AND THE INSTRUMENT WAS DETERMINED TO BE WORKING WITHIN SPECIFICATION. THE MANUFACTURER'S EVALUATION OF THE ROOT CAUSE IS ONGOING.

Description of Event or Problem · 1

THE SITE REPORTED THAT THERE WERE 5 POST-IMPLANTATION REFRACTIVE SURPRISES REQUIRING RE-IMPLANTATION OVER THE PAST YEAR. THIS IS THE INFORMATION FOR PATIENT (B)(6). THE INFORMATION FOR PATIENT (B)(6) HAS NOT BEEN PROVIDED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
136910 IOLMASTER 500 BIOMICROSCOPE, SLIT-LAMP, AC-POWERED HJO CARL ZEISS MEDITEC AG (JENA SITE) 500 NA

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention