FDA Adverse Event Injury Summary report: N

ALLEGRETTO WAVE EYE-Q

MDR report key: 3819992 · Received May 14, 2014

Report

Report Number
3003288808-2014-00843
Event Type
Injury
Date Received
May 14, 2014
Date of Event
February 26, 2014
Report Date
April 15, 2014
Manufacturer
WAVELIGHT GMBH
Product Code
LZS
PMA / PMN Number
P030008
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THE DEVICE HISTORY RECORDS (DHR) FOR THE DEVICE WAS REVIEWED AND THERE WERE NO UNUSUAL FINDINGS RELATED TO THE REPORTED ISSUE AND THE PRODUCT WAS RELEASED ACCORDING TO COMPANY ACCEPTABLE CRITERIA. ADDITIONAL INFO HAS BEEN REQUESTED. 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

A TECH REPORTED PT WITH TWO OR THREE PLUS PUNCTATE EPITHELIAL KERATITIS (PEK) WITH REDUCED TEAR FILM AND TEAR BREAKUP TIME AND DRY EYES AT TWO MONTH LASIK POST-OP VISIT. AT VISIT PT COMPLAINED OF "SOME BLURRINESS AND DRYNESS". ADDITIONAL INFO FROM REPORTED INDICATED PT'S ARTIFICIAL TEARS AND CYCLOSPORINE OPHTHALMIC SOLUTION DOSAGE WERE INCREASED. ADDITIONAL INFO HAS BEEN REQUESTED. THIS REPORT CAPTURES THE LEFT EYE, AND ADDITIONAL REPORT IS FILED FOR THE RIGHT EYE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
288898 ALLEGRETTO WAVE EYE-Q OPHTHALMIC EXCIMER LASER SYS LZS WAVELIGHT GMBH 8065990601 NA

Patients

Seq Age Sex Outcome Treatment
1 48 YR Required Intervention INRALASE