FDA Adverse Event
Injury
Summary report: N
ALLEGRETTO WAVE EYE-Q
MDR report key: 3760847
·
Received April 4, 2014
Report
- Report Number
- 3003288808-2014-00606
- Event Type
- Injury
- Date Received
- April 4, 2014
- Date of Event
- March 9, 2014
- Report Date
- March 9, 2014
- Manufacturer
- WAVELIGHT GMBH
- Product Code
- LZS
- PMA / PMN Number
- P030008
- Removal / Correction Number
- NA
- Adverse Event
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- MO, 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 ADD'L REPORTABLE INFO BECOMES AVAILABLE. (B)(4).
Description of Event or Problem · 1
AN OPTOMETRIST REPORTED PT WITH DIFFUSE LAMELLAR KERATITIS (DLK) AT ONE DAY LASIK POST-OPERATIVE VISIT. ADDITION INFO INDICATED PT'S TOPICAL STEROID DOSAGE WAS INCREASED AND THE REPORTED EVENT HAD RESOLVED. THIS REPORT REFERENCES THE LEFT EYE. AN ADD'L REPORT WILL BE FILED FOR THE RIGHT EYE.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 203766 | ALLEGRETTO WAVE EYE-Q | OPHTHALMIC EXCIMER LASER SYSTEM | LZS | WAVELIGHT GMBH | 8065990601 | NA |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 27 YR | Required Intervention | INTRALASE |