FDA Adverse Event Injury Summary report: N

ACRYSOF

MDR report key: 3891769 · Received June 10, 2014

Report

Report Number
9612169-2014-00066
Event Type
Injury
Date Received
June 10, 2014
Date of Event
February 5, 2014
Report Date
May 14, 2014
Manufacturer
ALCON LABORATORIES IRELAND LTD.
Product Code
HQL
PMA / PMN Number
P930014
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
BR
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

EVAL SUMMARY: THE PRODUCT WAS NOT RETURNED FOR ANALYSIS. RESULTS FROM THE PRODUCT HISTORY RECORD REVIEW INDICATED THE PRODUCT MET RELEASE CRITERIA. THE ROOT CAUSE FOR THE REPORTED COMPLAINT COULD NOT BE DETERMINED. BASED ON THE RESULTS FROM THE PRODUCT AND BATCH HISTORY RECORD, THE PRODUCT MET RELEASE CRITERIA. THERE HAS BEEN NO OTHER COMPLAINTS REPORTED IN THE LOT NUMBER. ADD'L INFO HAS BEEN REQUESTED. (B)(4).

Description of Event or Problem · 1

A CUSTOMER REPORTED THAT FOLLOWING BILATERAL INTRAOCULAR LENS (IOL) IMPLANT SURGERIES, SHE EXPERIENCED FLASHES, WAS NOT ABLE TO SEE IN THE LIGHT, HAD EYE DISCOMFORT, AND WAS UNABLE TO READ. THE SURGEON PERFORMED FLUORESCENCE ANGIOGRAPHY AND DETERMINED THE IOL'S TO BE CONTRIBUTING TO THESE SYMPTOMS. THE IOL'S REMAINED IMPLANTED. ADD'L INFO WAS REQUESTED. THERE ARE TWO MEDICAL DEVICE REPORTS ASSOCIATED WITH THIS EVENT. THIS REPORT IS ASSOCIATED WITH THE LEFT EYE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
338829 ACRYSOF INTRAOCULAR LENS HQL ALCON LABORATORIES IRELAND LTD. AN60WF 21078558

Patients

Seq Age Sex Outcome Treatment
1 48 YR Other MONARCH D CARTRIDGE AND RAYVISC