FDA Adverse Event Injury Summary report: N

ALLEGRETTO WAVE EYE-Q

MDR report key: 3771001 · Received December 18, 2013

Report

Report Number
3003288808-2013-00807
Event Type
Injury
Date Received
December 18, 2013
Date of Event
December 5, 2013
Report Date
December 5, 2013
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

AN OPTOMETRIST REPORTED PT WITH DRY EYE AND PHOTOPHOBIA AT LASIK POST-OPERATIVE VISIT. ADD'L INFO INDICATED THE PATIENT'S TOPICAL STEROID DOSAGE WAS INCREASED. THIS REPORT REFERENCES THE LEFT EYE. AN ADD'L REPORT WILL BE FILED FOR THE RIGHT EYE. ADD'L INFO HAS BEEN REQUESTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
663878 ALLEGRETTO WAVE EYE-Q OPHTHALMIC EXCIMER LASER SYSTEM LZS WAVELIGHT GMBH 8065990601 NA

Patients

Seq Age Sex Outcome Treatment
1 26 YR Required Intervention INTRALASE: