BEUDAMED
    FDA Adverse Event Injury Summary report: N

    ACRYSOF RESTOR

    MDR report key: 852385 · Received May 9, 2007

    Report

    Report Number
    1119421-2007-00173
    Event Type
    Injury
    Date Received
    May 9, 2007
    Date of Event
    April 5, 2007
    Report Date
    April 9, 2007
    Manufacturer
    ALCON LABORATORIES, INC. HUNTINGTON
    Product Code
    HQL
    PMA / PMN Number
    p040020
    Removal / Correction Number
    NA
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    FL, US
    Reporter Occupation
    PHYSICIAN

    Narratives

    Additional Manufacturer Narrative · 1

    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 060886 RECORDS WERE REVIEWED LENS MET RELEASE CRITERIA. THERE HAVE BEEN NO OTHER COMPLAINTS FOR THIS LOT NUMBER. ADD'L INFO WAS REQUESTED 4/9/2007, 4/10/2007, 4/16/2007, 4/20/2007 AND 4/26/2007 BY PHONE, MAIL AND FAX. ADD'L INFO WAS PROVIDED 4/16/2007 AND 4/18/2007 BY MAIL.

    Description of Event or Problem · 1

    THE OTHER MANUFACTURER REPORT NUMBERS ARE MDR #'S: 1119421-2007-00172, 1119421-2007-00174, 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 REQUESTED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 ACRYSOF RESTOR INTRAOCULAR LENS HQL ALCON LABORATORIES, INC. HUNTINGTON SN60D3 966707

    Patients

    Seq Age Sex Outcome Treatment
    1 63 YR Required Intervention