FDA Adverse Event
Injury
Summary report: N
WAVELIGHT EX500 EXCIMER LASER
MDR report key: 3255680
·
Received July 24, 2013
Report
- Report Number
- 3003288808-2013-00437
- Event Type
- Injury
- Date Received
- July 24, 2013
- Date of Event
- June 25, 2013
- Report Date
- June 26, 2013
- Manufacturer
- WAVELIGHT GMBH
- Product Code
- LZS
- PMA / PMN Number
- P030008
- Removal / Correction Number
- NA
- Adverse Event
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- MN, 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 TECH REPORTED A CASE OF AN UNDERCORRECTION AFTER BILATERAL LASIK. THE PT HAD VERY LARGE PUPILS AND THE SURGEON CHOSE TO USE A 7.0 OPTICAL ZONE (OZ) AS OPPOSED TO THE STANDARD 6.5 (OZ). THIS REPORT REFERENCES THE LEFT EYE. ANOTHER REPORT WILL BE FILED FOR THE RIGHT EYE. ADDITIONAL INFORMATION HAS BEEN REQUESTED.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 344955 | WAVELIGHT EX500 EXCIMER LASER | OPHTHALMIC EXCIMER LASER SYSTEM | LZS | WAVELIGHT GMBH | 8065990713 | NA |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 31 YR | Other |