FDA Adverse Event Injury Summary report: N

VISION ICL IMPLANTABLE COLLAMER LENS

MDR report key: 730933 · Received June 30, 2006

Report

Report Number
2023826-2006-00915
Event Type
Injury
Date Received
June 30, 2006
Report Date
June 2, 2006
Manufacturer
STAAR SURGICAL
Product Code
HQL
PMA / PMN Number
P030016
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
MN
Reporter Occupation
PHYSICIAN

Narratives

Description of Event or Problem · 1

THE REPORTER STATED THAT THE SURGEON IMPLANTED A VISIAN ICL (IMPLANTABLE COLLAMER LENS MODEL MICL 13.2 ON 05/25/2006 AND EXPLANTED THE LENS AT A LATER DATE DUE TO THE MICL HAVING AN EXCESSIVE VAULT. THE PATIENT WAS EXPERIENCING AN INCREASED INTRAOCULAR PRESSURE AND PUPILLARY BLOCKAGE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 VISION ICL IMPLANTABLE COLLAMER LENS INTRAOCULAR LENS HQL STAAR SURGICAL MICL13.2 NA

Patients

Seq Age Sex Outcome Treatment
1 44 YR Required Intervention CARTRIDGE MODEL: UNK, LOT NUMBER: UNK| INJECTOR MODEL: UNK, LOT NUMBER: UNK