ACRYSOF RESTOR
Report
- Report Number
- 1119421-2007-00174
- Event Type
- Injury
- Date Received
- May 9, 2007
- Date of Event
- March 16, 2007
- Report Date
- April 9, 2007
- Manufacturer
- ALCON LABORATORIES, INC. / HUNGTINGTON
- Product Code
- HQL
- PMA / PMN Number
- P040020
- Removal / Correction Number
- NA
- Adverse Event
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- FL, US
- Reporter Occupation
- OTHER
Narratives
THE PRODUCT WAS NOT RETURNED FOR ANALYSIS. STERILIZATION RECORDS WERE REVIEWED AND THE STERILIZATION CYCLE RAN WITHIN ALL REQUIRED PARAMETERS WITH NO ANOMALIES. PRODUCT HISTORY RECORD AND BATCH 060676 RECORDS WERE REVIEWED LENS MET RELEASE CRITERIA. THERE HAVE BEEN NO OTHER COMPLAINTS FOR THIS LOT NUMBER. THIS REPORT WAS MAILED TO THE FDA ON: 05/09/2007. ADDITIONAL INFORMATION WAS REQUESTED 04/09/2007, 04/10/2007, 04/16/2007, 04/20/2007 AND 04/26/2007 BY PHONE, MAIL AND FAX. ADDITIONAL INFORMATION WAS PROVIDED 04/16/2007 AND 04/18/2007 BY MAIL.
A SURGEON REPORTED FOUR PATIENTS EXPERIENCED TOXIC ANTERIOR SEGMENT SYNDROME (TASS) FOLLOWING INTRAOCULAR LENS (IOL) IMPLANT SURGERIES. SURGERIES OCCURED OVER A THREE WEEK PERIOD AND INVOLVED TWO SURGEONS. THIS REPORT IS BEING SUBMITTED AS MANUFACTURER NUMBER 1119421-2007-00174. THE OTHER MANUFACTURER REPORT NUMBERS ARE MDR #S: 1119421-2007-00172, 1119421-2007-00173, 1119421-2007-00175. NO PRODUCT, PROCEDURAL OR ENVIRONMENTAL FACTOR WAS IDENTIFIED AS A CAUSE. A POSSIBLE SITE VISIT IS BEING DISCUSSED WITH THE SURGEON TO ASSIST THE FACILITY IN IDENTIFYING POSSIBLE CONTRIBUTING FACTORS IN THESE CASES OF TASS. ADDITIONAL INFORMATION, INCLUDING PATIENT STATUS, HAS BEEN REQUEST.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1 | ACRYSOF RESTOR | INTRAOCULAR LENS | HQL | ALCON LABORATORIES, INC. / HUNGTINGTON | SN60WF | 964885 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 67 YR | Required Intervention |