FDA Adverse Event
Injury
Summary report: N
ALLEGRETTO WAVE EYE-Q
MDR report key: 3733023
·
Received March 27, 2014
Report
- Report Number
- 3003288808-2014-00559
- Event Type
- Injury
- Date Received
- March 27, 2014
- Date of Event
- February 25, 2014
- Report Date
- February 28, 2014
- Manufacturer
- WAVELIGHT GMBH
- Product Code
- LZS
- PMA / PMN Number
- P030008
- Adverse Event
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- IL, 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. ADDITIONAL INFORMATION HAS BEEN REQUESTED. (B)(4).
Description of Event or Problem · 1
A TECHNICIAN REPORTED A CASE OF SUB-EPITHEAL INFILTRATES (SEI), OBSERVED ON A PT'S RIGHT EYE DURING ROUTINE TWO WEEK POSTOP FOLLOW UP LASIK TREATMENT REPORTER INDICATED TOPICAL STEROID DOSAGE WERE INCREASED, AND PT WAS RUBBING HER EYES WITHIN THE LAST FEW DAYS. PT NOTED NO FOREIGN BODY SENSATION. ADDITIONAL INFORMATION HAS BEEN REQUESTED.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 179724 | ALLEGRETTO WAVE EYE-Q | OPHTHALMIC EXCIMER LASER SYSTEM | LZS | WAVELIGHT GMBH | 8065990601 | NA |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 31 YR | Required Intervention | INTRALASE |