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 |