FDA Adverse Event Other Summary report: N

LENSAR LASER SYSTEM -FS 3D

MDR report key: 3908591 · Received June 11, 2014

Report

Report Number
3009026057-2014-00011
Event Type
Other
Date Received
June 11, 2014
Date of Event
June 3, 2014
Report Date
June 11, 2014
Manufacturer
LENSAR INC.
Product Code
OOE
PMA / PMN Number
K120214
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
PA, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

FROM THE INVESTIGATION WAS DETERMINED THAT THE ARC CUT INCISIONS AND THE CLEAR CORNEAL INCISIONS OVERLAPPED BY 14 DEGREES. ROOT CAUSE: OPERATOR ERROR.

Description of Event or Problem · 1

ON (B)(6) 2014, A DOCTOR NOTED A PERFORATION IN THE TEMPORAL AI.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
346243 LENSAR LASER SYSTEM -FS 3D LENSAR LASER SYSTEM -FS 3D OOE LENSAR INC. NA NA

Patients

Seq Age Sex Outcome Treatment
1 UNK Other