BEUDAMED
    FDA Adverse Event Injury Summary report: N

    STAR

    MDR report key: 7341855 · Received March 15, 2018

    Report

    Report Number
    3006695864-2018-00527
    Event Type
    Injury
    Date Received
    March 15, 2018
    Date of Event
    December 15, 2017
    Report Date
    April 19, 2018
    Manufacturer
    JOHNSON & JOHNSON SURGICAL VISION, INC
    Product Code
    LZS
    UDI-DI
    00(01)(21)3790
    PMA / PMN Number
    P930016
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    OH, US
    Reporter Occupation
    PHYSICIAN

    Narratives

    Additional Manufacturer Narrative · 1

    (B)(4). ALL PERTINENT INFORMATION AVAILABLE TO JOHNSON & JOHNSON SURGICAL VISION, INC. HAS BEEN SUBMITTED.

    Additional Manufacturer Narrative · 1

    A REVIEW OF THE RECORDS RELATED TO THE DEVICE THAT INCLUDED LABELING, MANUALS, TRENDING, AND RISK DOCUMENTATION WAS PERFORMED. THE TREND REVIEW SHOWS THAT THERE IS NO SIGNIFICANT CHANGE OVER HISTORICAL COMPLAINT LIMITS AND NO RECOGNIZABLE ADVERSE TREND. THE RISKS AND MITIGATIONS ASSOCIATED WITH THE COMPLAINT ISSUE ARE IDENTIFIED IN EXISTING RISK DOCUMENTS AND NO NEW RISKS WERE IDENTIFIED AS PART OF THIS INVESTIGATION. THERE WAS NO PRODUCT DEFICIENCY IDENTIFIED. ALL PERTINENT INFORMATION AVAILABLE TO JOHNSON & JOHNSON SURGICAL VISION, INC. HAS BEEN SUBMITTED.

    Description of Event or Problem · 1

    THE SURGERY CENTER REPORTED THAT A LASER VISION CORRECTION PATIENT WAS PRESENTED WITH TRANSIENT LIGHT SENSITIVITY (TLS) ON BOTH EYES (OU) AT A 2-WEEK POST-OPERATIVE EXAM. A BRIEF DESCRIPTION FROM THE SURGERY CENTER INDICATED THE PATIENT HAD EXTREME LIGHT SENSITIVITY. THE PATIENT¿S COMMENTS WERE THAT BOTH EYES FEEL BURNING FREQUENTLY AND THE LEFT EYE FEELING OF FOREIGN BODY SENSATION. THE PATIENT STATES VISION IS FINE. TOPICAL STEROIDS WERE INCREASED TO TREAT THE SYMPTOMS. BCVA FROM (B)(6) 2018: RIGHT EYE POST-OP 20/20 -.50 X -.50 X 5, LEFT EYE POST-OP 20/20 -1.75 X -.50 X 0. THIS REPORT IS FOR THE VISX LASER EQUIPMENT. A SEPARATE REPORT WILL BE SUBMITTED FOR THE INTRALASE EQUIPMENT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    186747 STAR EXCIMER LASER LZS JOHNSON & JOHNSON SURGICAL VISION, INC 0030-1479 00(01)(21)3790

    Patients

    Seq Age Sex Outcome Treatment
    1 48 YR Required Intervention INTRALASE NO. (B)(4)