FDA Adverse Event Injury Summary report: N

VISCOJECT 1.8 DELIVERY SYSTEM

MDR report key: 3164087 · Received June 6, 2013

Report

Report Number
1119279-2013-00181
Event Type
Injury
Date Received
June 6, 2013
Date of Event
May 2, 2013
Report Date
May 8, 2013
Manufacturer
MEDICEL AG
Product Code
MSS
PMA / PMN Number
K092023
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
MN, 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 TO AN UNSPECIFIED REASON. THE INCISION WAS ENLARGED TO REMOVE THE LENS AND A THREE PIECE LENS WAS SUCCESSFULLY IMPLANTED IN THE SULCUS. ADDITIONAL INFORMATION HAS BEEN REQUESTED. REFERENCE MDR NUMBER 1119279-2013-00180 FOR THE LENS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
251866 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)