FDA Adverse Event Injury Summary report: N

INTRALASE FS2

MDR report key: 7372439 · Received March 26, 2018

Report

Report Number
3006695864-2018-00597
Event Type
Injury
Date Received
March 26, 2018
Date of Event
February 26, 2018
Report Date
April 25, 2018
Manufacturer
JOHNSON & JOHNSON SURGICAL VISION, INC
Product Code
HNO
PMA / PMN Number
K060372
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
IL, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

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 BLURRY VISION IN THE RIGHT EYE(OD) AT THE 2-DAY POST OP EXAM. THE PATIENT¿S CHIEF COMPLAINT WAS OF BLURRED VISION IN THE OD. THE SURGERY CENTER ARRANGED A FLAP LIFT TREATMENT TO RESOLVE THE SYMPTOMS. THE SURGERY CENTER REPORTED THE SYMPTOMS HAVE BEEN RESOLVED. BEST CORRECTED VISUAL ACUITY (BCVA) FROM (B)(6) 2018: RIGHT EYE PRE-OP 20/20 5.25 X .00 X 90, LEFT EYE PRE-OP 20/20 5.00 X .00 X 90.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
215209 INTRALASE FS2 FEMTOSECOND LASER HNO JOHNSON & JOHNSON SURGICAL VISION, INC 20003D

Patients

Seq Age Sex Outcome Treatment
1 44 YR Required Intervention WAVELIGHT SERIAL NO. (B)(4)