FDA Adverse Event Injury Summary report: N

ALLEGRETTO WAVE EYE-Q

MDR report key: 3760848 · Received April 4, 2014

Report

Report Number
3003288808-2014-00607
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) OF THE RIGHT EYE AT ONE DAY LASIK POST-OPERATIVE VISIT. ADDITION INFO INDICATED PT'S TOPICAL STEROID DOSAGE WAS INCREASED AND THE REPORTED EVENT HAD RESOLVED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
203699 ALLEGRETTO WAVE EYE-Q OPHTHALMIC EXCIMER LASER SYSTEM LZS WAVELIGHT GMBH 8065990601 NA

Patients

Seq Age Sex Outcome Treatment
1 25 YR Required Intervention INTRALASE