FDA Adverse Event Other Summary report: N

LENSAR LASER SYSTEM -FS 3D

MDR report key: 4073010 · Received September 2, 2014

Report

Report Number
3009026057-2014-00020
Event Type
Other
Date Received
September 2, 2014
Date of Event
July 29, 2014
Report Date
August 27, 2014
Manufacturer
LENSAR INC
Product Code
OOE
PMA / PMN Number
K120214
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
AS
Reporter Occupation
PHYSICIAN

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 INFO BECOMES AVAILABLE.

Description of Event or Problem · 1

DOCTOR REPORTED TO A LENSAR DISTRIBUTOR THAT THE CAPSULOTOMY WAS INCOMPLETE RESULTING IN A RADIAL TEAR AROUND THE POSTERIOR CAPSULE REQUIRING THE PLACEMENT OF AN IOL IN THE SULCUS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
532337 LENSAR LASER SYSTEM -FS 3D LENSAR LASER SY -FS 3D OOE LENSAR INC NA NA

Patients

Seq Age Sex Outcome Treatment
1 UNK Other