FDA Adverse Event
Injury
Summary report: N
INTRALASE FS2
MDR report key: 4221612
·
Received November 3, 2014
Report
- Report Number
- 3006695864-2014-00501
- Event Type
- Injury
- Date Received
- November 3, 2014
- Date of Event
- September 18, 2014
- Report Date
- October 6, 2014
- Manufacturer
- ABBOTT MEDICAL OPTICS
- Product Code
- HNO
- PMA / PMN Number
- K060372
- Adverse Event
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- UT, US
- Reporter Occupation
- PHYSICIAN
Narratives
Additional Manufacturer Narrative · 1
DATE OF EVENT: (B)(6) 2014. (B)(6). ALL PERTINENT INFORMATION AVAILABLE TO ABBOTT MEDICAL OPTICS HAS BEEN SUBMITTED.
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 EPITHELIAL INGROWTH IN RIGHT EYE (INFERIOR) ALMOST 2 MONTHS POST TREATMENT. ACCOUNT REPORTED THAT PATIENT HAD A FLAP LIFT AND RINSE PERFORMED. IT WAS STATED THAT THE PATIENT HAD NO LOSS OF BEST CORRECTED VISUAL ACUITY (BCVA). THE PATIENT COMPLAINED OF FOREIGN BODY SENSATION.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 703040 | INTRALASE FS2 | FEMTOSECOND LASER | HNO | ABBOTT MEDICAL OPTICS | 20003D |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 33 YR | Required Intervention | WAVELIGHT (B)(4) |