FDA Adverse Event Injury Summary report: N

ALLEGRETTO WAVE EYE-Q

MDR report key: 3042182 · Received April 4, 2013

Report

Report Number
3003288808-2013-00155
Event Type
Injury
Date Received
April 4, 2013
Report Date
March 8, 2013
Manufacturer
WAVELIGHT GMBH
Product Code
LZS
PMA / PMN Number
P030008
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
CA, 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

A SURGEON REPORTED 20 LASIK RETREATMENTS ON EYES DUE TO THE FACT THAT THIS SURGIVISION DATA LINK ACCESS WAS CUT-OFF IMMEDIATELY. THE SURGEON REPORTED PATIENTS WERE RETREATED AND ARE SATISFIED AND ARE NOT COMPLAINING OF ON-GOING ISSUES. ADDITIONAL INFORMATION HAS BEEN REQUESTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
138167 ALLEGRETTO WAVE EYE-Q OPHTHALMIC EXCIMER LASER SYSTEM LZS WAVELIGHT GMBH 8065990601 NA

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention SURGIVISION DATALINK NOMOGRAM