FDA Adverse Event Other Summary report: N

COLLAMER ULTRAVIOLET-ABSORBING POSTERIOR CHAMBER THREE PIECE FOLDABLE INTRAOCULA

MDR report key: 992377 · Received February 7, 2008

Report

Report Number
2023826-2008-00154
Event Type
Other
Date Received
February 7, 2008
Date of Event
September 5, 2007
Report Date
January 11, 2008
Manufacturer
STAAR SURGICAL CO.
Product Code
HQL
PMA / PMN Number
P990013
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
OH, US
Reporter Occupation
NURSE

Narratives

Additional Manufacturer Narrative · 1

RESULTS: VISUAL INSPECTION OF THE RETURNED PRODUCT SHOWED THAT LENS WAS RECEIVED STUCK INSIDE ANOTHER MANUFACTURER'S CARTRIDGE.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE SURGEON WAS ATTEMPTING TO INSERT A CQ2015A THREE PIECE COLLAMER LENS AND A HAPTIC GOT CAUGHT WHILE ADVANCING IN THE CARTRIDGE. THERE WAS NO PT CONTACT. THE REPORTER STATED THE INCIDENT WAS DUE TO A LOADING ERROR. THIS IS ONE OF TWO INCIDENTS INVOLVING THIS PT (SEE MFR REPORT # 023826-2008-00153).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 COLLAMER ULTRAVIOLET-ABSORBING POSTERIOR CHAMBER THREE PIECE FOLDABLE INTRAOCULA INTRAOCULAR LENS HQL STAAR SURGICAL CO. CQ2015A NA

Patients

Seq Age Sex Outcome Treatment
1 INJECTOR MODEL UNK| CARTRIDGE MODEL UNK