FDA Adverse Event Injury Summary report: N

CATALYS SYSTEM

MDR report key: 8664016 · Received June 3, 2019

Report

Report Number
3005675890-2019-00049
Event Type
Injury
Date Received
June 3, 2019
Report Date
November 12, 2020
Manufacturer
JOHNSON & JOHNSON SURGICAL VISION, INC.
Product Code
OOE
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 0

THIS CORRECTION MDR IS BEING SUBMITTED TO ADDRESS INACCURATE INFORMATION IN SECTION F ON THE XML VERSION OF THE PREVIOUS SUBMISSION CAUSED BY A SOFTWARE GLITCH IN THE TRANSMISSION PROCESS. THE INTERNAL NON-CONFORMANCE NUMBERS FOR THIS SOFTWARE ISSUE ARE NR-0148919 AND CAPA: 010215.

Additional Manufacturer Narrative · 1

DATE OF EVENT: DATE UNKNOWN/NOT PROVIDED. (B)(6). SERIAL#: UNKNOWN/NOT PROVIDED. UDI #: A COMPLETE UDI # IS UNKNOWN AS PRODUCT SERIAL NUMBER WAS NOT PROVIDED. PMA/510K: THIS REPORT IS BEING FILED ON AN INTERNATIONAL PRODUCT; LASER CORRECTION SYSTEM, MODEL CATALYS-I, THAT HAS A SIMILAR PRODUCT, CATALYS-U WHICH IS DISTRIBUTED IN THE UNITED STATES UNDER 510(K) # K121091. DEVICE EVALUATED BY MFR: A REVIEW OF RECORDS RELATED TO THE DEVICE INCLUDING LABELING, COMPLAINT TRENDING, AND RISK DOCUMENTATION WILL BE PERFORMED. UPON COMPLETION OF THIS REVIEW, IF THERE IS ANY FURTHER RELEVANT INFORMATION OBTAINED, A SUPPLEMENTAL MEDWATCH WILL BE FILED. DEVICE MANUFACTURE DATE: UNKNOWN, AS THE SERIAL NUMBER OF THE DEVICE WAS NOT PROVIDED. (B)(4). ALL PERTINENT INFORMATION AVAILABLE TO JOHNSON & JOHNSON SURGICAL VISION, INC HAS BEEN SUBMITTED.

Description of Event or Problem · 1

IT WAS REPORTED THAT PATIENT HAD CATARACT PROCEDURE WITH SYSTEM AND HAD SIGNIFICANT ENDOTHELIAL CELL LOSS. IT WAS REPORTED THAT SURGEON SIGNIFICANTLY INCREASED THE LASER ENERGY SETTINGS FOR EXPERIMENTAL REASONS. PRE-OPERATIVE ENDOTHELIAL CELL COUNT: 2985 CELLS/MM2, POST-OPERATIVE ENDOTHELIAL CELL COUNT: 2551 CELLS/MM2, PATIENT OUTCOME: FINE (NO VISUAL ACUITY PROBLEMS).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
457465 CATALYS SYSTEM CATALYS OOE JOHNSON & JOHNSON SURGICAL VISION, INC. CATALYS-I

Patients

Seq Age Sex Outcome Treatment
1 64 YR Other