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) |