FDA Adverse Event
Injury
Summary report: N
ALLEGRETTO WAVE EYE-Q
MDR report key: 4173917
·
Received October 1, 2014
Report
- Report Number
- 3003288808-2014-01470
- Event Type
- Injury
- Date Received
- October 1, 2014
- Date of Event
- September 5, 2014
- Report Date
- September 5, 2014
- Manufacturer
- WAVELIGHT GMBH
- Product Code
- LZS
- PMA / PMN Number
- P030008
- Adverse Event
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- NJ, 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 WERE REVIEWED. THE ASSOCIATED DEVICE WAS RELEASED BASED ON THE COMPANY'S ACCEPTANCE CRITERIA. (B)(4).
Description of Event or Problem · 1
AN OPTOMETRIST REPORTED A PATIENT WITH A CORNEAL ABRASION AND DRYNESS IN THE RIGHT EYE AT THE ONE WEEK POST (PRK) PHOTOREFRACTIVE KERATECTOMY VISIT. PATIENT EXPRESSED HAVING TEARING AND PAIN. A BANDAGE CONTACT LENS WAS PLACED ON THE EYE AND ANTIBIOTIC DROPS WERE STARTED. THE REPORTED CORNEAL ABRASION HAS HEALED AND THE REPORTED DRYNESS HAS IMPROVED.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 611526 | ALLEGRETTO WAVE EYE-Q | OPHTHALMIC EXCIMER LASER SYSTEM | LZS | WAVELIGHT GMBH | 8065990601 | NA |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 32 YR | Required Intervention |