BEUDAMED
    FDA Adverse Event Injury Summary report: N

    ALLEGRETTO WAVE EYE-Q

    MDR report key: 3912625 · Received June 13, 2014

    Report

    Report Number
    3003288808-2014-00980
    Event Type
    Injury
    Date Received
    June 13, 2014
    Date of Event
    January 6, 2014
    Report Date
    May 16, 2014
    Manufacturer
    WAVELIGHT GMBH
    Product Code
    LZS
    PMA / PMN Number
    P030008
    Removal / Correction Number
    NA
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    OH, 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. THE DEVICE HISTORY RECORDS (DHR) FOR THE DEVICE WAS REVIEWED. THE ASSOCIATED DEVICE WAS RELEASED BASED ON COMPANY ACCEPTANCE CRITERIA. (B)(4).

    Description of Event or Problem · 1

    A TECHNICIAN REPORTED A CASE OF BILATERAL MODERATE DRY EYES, OBSERVED AT THREE DAYS POST LASIK TREATMENT. REPORTER INDICATED A BANDAGE CONTACT LENS INSERTED, AND PATIENT CONTINUED WITH THE NORMAL POST OP EYE DROP PROTOCOL. REPORTER NOTED THE SURGEON DID NOT FEEL THIS EVENT WAS RELATED TO THE EXCIMER LASER. PATIENT NOTED BLURRY VISION. THERE ARE TWO RELATED REPORTS FOR THIS PATIENT. THIS REPORT ADDRESSES THE PATIENT'S RIGHT EYE, AND ANOTHER MANUFACTURER REPORT WILL BE FILED FOR THE FELLOW EYE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    348986 ALLEGRETTO WAVE EYE-Q OPHTHALMIC EXCIMER LASER SYSTEM LZS WAVELIGHT GMBH 8065990601 NA

    Patients

    Seq Age Sex Outcome Treatment
    1 56 YR Required Intervention INTRALASE ON