FDA Adverse Event Other Summary report: N

SMARTPLUG

MDR report key: 520390 · Received April 9, 2004

Report

Report Number
2031959-2004-00008
Event Type
Other
Date Received
April 9, 2004
Report Date
April 9, 2004
Manufacturer
MEDENNIUM, INC.
Product Code
LZU
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
WA, US
Reporter Occupation
PHYSICIAN

Narratives

Description of Event or Problem · 1

"DR'S OFFICE REPORTED THAT A PT CAME IN, WAS DIAGNOSED WITH DRY EYE SYNDROME, WAS A PREVIOUS SILICONE PLUG USER AND SMARTPLUG WAS INSERTED AFTER PATENCY WAS ASSESSED. THE PT RETURNED A FEW DAYS LATER COMPLAINING OF PAIN IN THE RIGHT EYE AND WAS DIAGNOSED WITH AN INFECTION IN THAT EYE. DR PUT THE PT ON KEFLEX (DOSE AND REGIMEN UNKNOWN) AND THE PT IS TO RETURN IN A FEW DAYS FOR FOLLOW UP."

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 SMARTPLUG PUNCTUM PLUG LZU MEDENNIUM, INC. MODEL 500 UNK

Patients

Seq Age Sex Outcome Treatment
1 UNKNOWN Other