FDA Adverse Event Injury Summary report: N

ALLEGRETTO WAVE EYE-Q

MDR report key: 3760876 · Received April 4, 2014

Report

Report Number
3003288808-2014-00596
Event Type
Injury
Date Received
April 4, 2014
Date of Event
February 14, 2014
Report Date
March 12, 2014
Manufacturer
WAVELIGHT GMBH
Product Code
LZS
PMA / PMN Number
P030008
Removal / Correction Number
NA
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 ADD'L REPORTABLE INFO BECOMES AVAILABLE. (B)(4).

Description of Event or Problem · 1

A TECHNICIAN REPORTED THAT AT ONE MONTH POST BILATERAL LASIK, THE PATIENT HAD PHOTOPHOBIA AND A HYPEROPIC REFRACTION IN THE LEFT EYE. THEY HAVE INCREASED THE STEROID DROP USE. ANOTHER REPORT IS FILED FOR THE RIGHT EYE. ADD'L INFO HAS BEEN REQUESTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
203771 ALLEGRETTO WAVE EYE-Q OPHTHALMIC EXCIMER LASER SYSTEM LZS WAVELIGHT GMBH 8065990601 NA

Patients

Seq Age Sex Outcome Treatment
1 30 YR Required Intervention INTRALASE