BEUDAMED
    FDA Adverse Event Injury Summary report: N

    ALLEGRETTO WAVE EYE-Q

    MDR report key: 4223675 · Received October 31, 2014

    Report

    Report Number
    3003288808-2014-01600
    Event Type
    Injury
    Date Received
    October 31, 2014
    Date of Event
    June 5, 2014
    Report Date
    October 3, 2014
    Manufacturer
    WAVELIGHT GMBH
    Product Code
    LZS
    PMA / PMN Number
    P030008
    Removal / Correction Number
    NA
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    VA, 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. (B)(4).

    Description of Event or Problem · 1

    AN OPTOMETRIST REPORTED A PATIENT WITH BLURRY DISTANCE VISION AT TWO WEEK LASIK POST-OPERATIVE VISIT. AT VISIT PATIENT COMPLAINED OF "BLURRY VISION IN THE DISTANCE IN BOTH EYES; HARD TO SEE STREET SIGNS". THIS REPORT REFERENCES THE LEFT EYE. AN ADDITIONAL REPORT WILL BE FILED FOR THE RIGHT EYE. ADDITIONAL INFORMATION HAS BEEN REQUESTED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    698118 ALLEGRETTO WAVE EYE-Q OPHTHALMIC EXCIMER LASER SYSTEM LZS WAVELIGHT GMBH 8065990601 NA

    Patients

    Seq Age Sex Outcome Treatment
    1 64 YR Other INTRALASE