FDA Adverse Event Injury Summary report: N

WAVELIGHT FS200 FEMTOSECOND LASER

MDR report key: 3214028 · Received July 3, 2013

Report

Report Number
3003288808-2013-00397
Event Type
Injury
Date Received
July 3, 2013
Date of Event
June 1, 2013
Report Date
June 6, 2013
Manufacturer
WAVELIGHT GMBH
Product Code
GEX
PMA / PMN Number
K101006
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
IT
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 THAT A PATIENT EXPERIENCED RAINBOW GLARE FOLLOWING LASIK SURGERY. ADDITIONAL INFORMATION HAS BEEN REQUESTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
304146 WAVELIGHT FS200 FEMTOSECOND LASER OPHTHALMIC FEMTOSECOND LASER GEX WAVELIGHT GMBH FS200 NA

Patients

Seq Age Sex Outcome Treatment
1 UNK Other