BEUDAMED
    FDA Adverse Event Injury Summary report: N

    STAR

    MDR report key: 7368921 · Received March 26, 2018

    Report

    Report Number
    3006695864-2018-00585
    Event Type
    Injury
    Date Received
    March 26, 2018
    Date of Event
    February 26, 2018
    Report Date
    April 26, 2018
    Manufacturer
    JOHNSON & JOHNSON SURGICAL VISION, INC
    Product Code
    LZS
    UDI-DI
    00(01)(21)5330
    PMA / PMN Number
    P930016
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    TX, US
    Reporter Occupation
    PHYSICIAN

    Narratives

    Additional Manufacturer Narrative · 1

    MANUFACTURER YEAR 2003. 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 EXPERIENCED FUZZY VISION, FLUCTUATION, AND FOREIGN BODY SENSATION IN THE RIGHT EYE (OD) AT THE 2-DAY POST OP EXAM. ORAL STEROIDS (PREDNISONE) WERE PRESCRIBED AND TOPICAL STEROID DOSAGE WAS INCREASED TO RESOLVE SYMPTOMS. BEST CORRECTED VISUAL ACUITY (BCVA) FROM (B)(6) 2017: RIGHT EYE PRE-OP 20/20 -.25 X -.75 X 95, LEFT EYE PRE-OP 20/20 -.50 X -.50 X 75. THIS REPORT IS FOR THE EXCIMER LASER. A SEPARATE REPORT WILL BE SUBMITTED FOR THE FEMTO LASER.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    213426 STAR EXCIMER LASER LZS JOHNSON & JOHNSON SURGICAL VISION, INC 0030-2450 00(01)(21)5330

    Patients

    Seq Age Sex Outcome Treatment
    1 36 YR Required Intervention FEMTO LASER SERIAL NO. (B)(4)