BEUDAMED
    FDA Adverse Event Injury Summary report: N

    INTRALASE FS2

    MDR report key: 7376499 · Received March 28, 2018

    Report

    Report Number
    3006695864-2018-00604
    Event Type
    Injury
    Date Received
    March 28, 2018
    Date of Event
    February 22, 2018
    Report Date
    April 30, 2018
    Manufacturer
    JOHNSON & JOHNSON SURGICAL VISION, INC
    Product Code
    HNO
    PMA / PMN Number
    K060372
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    NJ, US
    Reporter Occupation
    PHYSICIAN

    Narratives

    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.

    Additional Manufacturer Narrative · 1

    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 PRESENTED WITH DIFFUSE LAMELLAR KERATITIS (DLK) STAGE 1 IN THE RIGHT EYE (OD) AT THE 1-WEEK POST OP EXAM. A BRIEF DESCRIPTION FROM THE SURGERY CENTER INDICATED THE PATIENT HAD DLK STAGE 1, BLURRY VISION AND DRY EYE. THE PATIENT¿S COMMENTS WERE OF EYES FEELING VERY DRY AND VISION IS BLURRY IN THE RIGHT EYE. ORAL STEROIDS (MEDROL DOSE PAK) WERE PRESCRIBED AND TOPICAL STEROID DOSAGE WAS INCREASED TO RESOLVE SYMPTOMS. THE SURGERY CENTER REPORTED THE PATIENT IS NOT COMPLIANT WITH THE MEDICATIONS PRESCRIBED AS THE PATIENT DID NOT TAKE THE TOPICAL STEROID DROP DOSAGE. THE SURGERY CENTER NOTED THE PATIENT LOST THE MEDROL DOSE PACK AFTER THE SECOND DAY. BEST CORRECTED VISUAL ACUITY (BCVA) FROM (B)(6) 2018: RIGHT EYE PRE-OP 20/20 -3.00 X -.75 X 0; LEFT EYE PRE-OP 20/20 -3.00 X -1.25 X 170.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    222494 INTRALASE FS2 FEMTOSECOND LASER HNO JOHNSON & JOHNSON SURGICAL VISION, INC 20003D

    Patients

    Seq Age Sex Outcome Treatment
    1 28 YR Required Intervention WAVELIGHT SERIAL NO. (B)(4)