FDA Adverse Event Injury Summary report: N

VISCOJECT 1.8 DELIVERY SYSTEM

MDR report key: 3123625 · Received May 17, 2013

Report

Report Number
1119279-2013-00158
Event Type
Injury
Date Received
May 17, 2013
Date of Event
April 10, 2013
Report Date
April 19, 2013
Manufacturer
MEDICEL AG
Product Code
MSS
PMA / PMN Number
K092023
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
WA, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

THE DELIVERY DEVICE WAS REQUESTED, BUT WAS NOT RETURNED TO B+L FOR EVALUATION. 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 THE LENS WAS INTRAOPERATIVELY REMOVED FROM THE PATIENT'S EYE DUE A DAMAGED HAPTIC AND OPTIC NOTED DURING IMPLANTATION. THE INCISION WAS ENLARGED TO REMOVE THE LENS AND BACK LENS WAS SUCCESSFULLY IMPLANTED. THE PROGNOSIS WAS REPORTED AS "GOOD, NO PROBLEMS". PLEASE REFERENCE MDR#: 1119279-2013-00157 FOR THE LENS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
218573 VISCOJECT 1.8 DELIVERY SYSTEM MSS/IOL INJECTOR SET MSS MEDICEL AG LP604350

Patients

Seq Age Sex Outcome Treatment
1 Other AKREOS MICRO INCISION LENS (B+L)