FDA Adverse Event Injury Summary report: N

ALLEGRETTO WAVE EYE-Q

MDR report key: 3770988 · Received December 18, 2013

Report

Report Number
3003288808-2013-00852
Event Type
Injury
Date Received
December 18, 2013
Date of Event
November 27, 2013
Report Date
November 27, 2013
Manufacturer
WAVELIGHT GMBH
Product Code
LZS
PMA / PMN Number
P030008
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
AZ, 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. (B)(4).

Description of Event or Problem · 1

AN OPTHALMIC TECHNICIAN REPORTED PATIENT WITH DRY EYE AND SUPERFICIAL PUNCTATE KERATITIS (SPK), AT LASIK POST-OPERATIVE VISIT. THIS REPORT REFERENCES THE LEFT EYE. AN ADDITIONAL REPORT WILL BE FILED FOR THE LEFT EYE. ADDITIONAL INFORMATION HAS BEEN REQUESTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
664188 ALLEGRETTO WAVE EYE-Q OPTHALMIC EXCIMER LASER SYSTEM LZS WAVELIGHT GMBH 8065990601 NA

Patients

Seq Age Sex Outcome Treatment
1 34 YR Other INTRALASE