FDA Adverse Event Injury Summary report: N

SOFPORT INTRAOCULAR LENS

MDR report key: 4203030 · Received October 23, 2014

Report

Report Number
1119279-2014-00251
Event Type
Injury
Date Received
October 23, 2014
Date of Event
August 18, 2014
Report Date
September 26, 2014
Manufacturer
BAUSCH & LOMB, INC.
Product Code
HQL
PMA / PMN Number
P910061
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
MN, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

THE DEVICE WAS RECEIVED FOR EVALUATION. INVESTIGATION OF THIS EVENT IS IN PROGRESS. A SUPPLEMENTAL REPORT WILL BE SUBMITTED UPON COMPLETION OF THE INVESTIGATION.

Description of Event or Problem · 1

IT WAS REPORTED THAT DURING LENS INSERTION THE LENS BENT. THE INCISION WAS ENLARGED TO REMOVE THE LENS AND ANOTHER LENS WAS IMPLANTED. SUTURES WERE PLACED. PLEASE REFERENCE MDR # 1119279-2014-00252 FOR THE INSERTER USED IN THIS EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
674904 SOFPORT INTRAOCULAR LENS INTRAOCULAR LENS HQL BAUSCH & LOMB, INC. LI61SE 4370228

Patients

Seq Age Sex Outcome Treatment
1 Other EZ-28 DELIVERY DEVICE