BEUDAMED
    FDA Adverse Event Injury Summary report: N

    INTRALASE FS2

    MDR report key: 4220960 · Received November 3, 2014

    Report

    Report Number
    3006695864-2014-00499
    Event Type
    Injury
    Date Received
    November 3, 2014
    Date of Event
    October 3, 2014
    Report Date
    October 4, 2014
    Manufacturer
    ABBOTT MEDICAL OPTICS
    Product Code
    HNO
    PMA / PMN Number
    K060372
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    VA, US
    Reporter Occupation
    PHYSICIAN

    Narratives

    Additional Manufacturer Narrative · 1

    ALL PERTINENT INFORMATION AVAILABLE TO ABBOTT MEDICAL OPTICS HAS BEEN SUBMITTED. PLACEHOLDER.

    Additional Manufacturer Narrative · 1

    (B)(4). THE CLINIC IS REPORTING THIS ADVERSE EVENT ONLY AND DID NOT REQUEST OR REQUIRE FIELD SERVICE OR CLINICAL SUPPORT. ALL PERTINENT INFORMATION AVAILABLE TO ABBOTT MEDICAL OPTICS HAS BEEN SUBMITTED. PLACEHOLDER.

    Description of Event or Problem · 1

    THE CLINIC REPORTED THAT A LASER VISION CORRECTION PATIENT PRESENTED WITH LOSS OF BEST CORRECTED VISUAL ACUITY (BCVA) AND BLURRY VISION 22 MONTHS AFTER SURGERY. THE PATIENT HAD NO COMMENTS/AGREED TO SEE SPECIALIST. PATIENT WAS SEND FOR A SECOND OPINION AND CHECK FOR RETINAL DISEASE. BCVA: RIGHT EYE PRE-OP 20/20 POST-OP 20/40. LEFT EYE PRE-OP 20/20 POST-OP 20/40 .

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    703308 INTRALASE FS2 FEMTOSECOND LASER HNO ABBOTT MEDICAL OPTICS 20003D

    Patients

    Seq Age Sex Outcome Treatment
    1 26 YR Other WAVELIGHT (B)(4)