FDA Adverse Event
Malfunction
Summary report: N
ENVISTA INTRAOCULAR LENS
MDR report key: 4701983
·
Received April 15, 2015
Report
- Report Number
- 1313525-2015-00782
- Event Type
- Malfunction
- Date Received
- April 15, 2015
- Report Date
- March 20, 2015
- Manufacturer
- BAUSCH & LOMB
- Product Code
- HQL
- PMA / PMN Number
- P910056
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- IN
- Reporter Occupation
- PHYSICIAN
Narratives
Additional Manufacturer Narrative · 1
INVESTIGATION IS UNDERWAY. A SUPPLEMENTAL REPORT WILL BE SUBMITTED UPON COMPLETION OF THE INVESTIGATION.
Description of Event or Problem · 1
IT WAS REPORTED THAT THERE WAS NOT SALINE SOLUTION IN THE LENS VIAL AND THE LENS WAS HARD AND IT COULD NOT BE FOLDED IN THE INJECTOR. WHITE CRYSTALS WERE FOUND STICKING TO THE LENS. THE LENS WAS NOT USED. THIS ISSUE OCCURRED WITH 10 LENSES. THIS REPORT REFERENCE LENS 10 OF 10. REF MDR# 1313525-2015-00773 FOR LENS 1 OF 10; -00774 FOR LENS 2 OF 10; -00775 FOR LENS 3 OF 10; -00776 FOR LENS 4 OF 10; -00777 FOR LENS 5 OF 10; -00778 FOR LENS 6 OF 10; -00779 FOR LENS 7 OF 10; -00780 FOR LENS 8 OF 10; -00781 FOR LENS 9 OF 10.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 252747 | ENVISTA INTRAOCULAR LENS | INTRAOCULAR LENS | HQL | BAUSCH & LOMB | MX60A | 3364106 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 |