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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ALCON RESEARCH, LLC - HUNTINGTON ACRYSOF IQ SINGLEPIECE IOL WITH ULTRASERT DELIVERY SYSTEM; INTRAOCULAR LENS

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ALCON RESEARCH, LLC - HUNTINGTON ACRYSOF IQ SINGLEPIECE IOL WITH ULTRASERT DELIVERY SYSTEM; INTRAOCULAR LENS Back to Search Results
Model Number AU00T0
Device Problems Failure to Eject (4010); Physical Resistance/Sticking (4012)
Patient Problem Insufficient Information (4580)
Event Date 11/24/2023
Event Type  malfunction  
Manufacturer Narrative
Evaluation summary: investigation including root cause analysis is in progress.A supplemental mdr will be filed as necessary in accordance with 21 cfr 803.56 when additional reportable information becomes available.The manufacturer internal reference number is: (b)(4).
 
Event Description
A healthcare professional reported that during an intraocular lens (iol) implant procedure, the lens moved very sluggishly and the plunger had to be pushed forward with force.The doctor couldn't place this lens in the eye.The procedure completed with the replacement lens.Additional information has been requested.
 
Manufacturer Narrative
The product was not returned.Product history records were reviewed and the documentation indicated the product met release criteria.Viscoelastic information was not provided.It is unknown if a qualified viscoelastic was used.The root cause for the reported complaint may be related to a failure to follow the instruction for use (ifu).Information indicated that ¿additional viscoelastic substance had to be added to the inserter, and it was refrigerated.".Per the instruction for use: do not attempt to add ophthalmic viscoelastic device (ovd) to the device after the lens stop has been removed or lens damage may result.Do not attempt to retract the plunger after the plunger lock has been removed or plunger damage may result.Take at least 7 seconds to gently fold the intra ocular lens (iol) by advancing the plunger forward in one smooth, continuous motion until the front edge of the optic is even with the ¿fill-to¿ line on the nozzle.Do not allow any portion of the lens to exit the nozzle tip.At this position the blue spring will contact the clear main body.It is important to not advance the plunger abruptly to fold the iol as improper folding and lens damage may occur.The file indicated that the additional viscoelastic that was added, was refrigerated.Per the ifu: only use an company ovd qualified for use with the company pre-loaded delivery system that has been allowed to come to the operating room temperature.It is unknown if a qualified viscoelastic was used.The ifu instructs: during device preparation and implantation of the company model iol with the company preloaded delivery system, an company qualified ovd should be used.The use of an unqualified ovd may cause damage to the lens and potential complications during the device preparation and implantation steps.Information was provided in the file follow up section that the customer does not agree to contact.The file has been completed based on available provided information.If the sample becomes available for evaluation, the file will be reopened and updated.The manufacturer internal reference number is: (b)(4).
 
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Brand Name
ACRYSOF IQ SINGLEPIECE IOL WITH ULTRASERT DELIVERY SYSTEM
Type of Device
INTRAOCULAR LENS
Manufacturer (Section D)
ALCON RESEARCH, LLC - HUNTINGTON
6065 kyle lane
huntington WV 25702
Manufacturer (Section G)
ALCON RESEARCH, LLC - HUNTINGTON
6065 kyle lane
huntington WV 25702
Manufacturer Contact
jonathan schlech
6201 south freeway
mail stop ab2-6
fort worth, TX 76134
8007579780
MDR Report Key18396753
MDR Text Key331374867
Report Number1119421-2023-02218
Device Sequence Number1
Product Code HQL
UDI-Device Identifier00380652394734
UDI-Public00380652394734
Combination Product (y/n)N
Reporter Country CodeFI
PMA/PMN Number
P930014
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Foreign,Health Professional
Reporter Occupation Other Health Care Professional
Type of Report Initial,Followup
Report Date 02/09/2024
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received12/27/2023
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Operator Health Professional
Device Model NumberAU00T0
Device Lot Number15476719
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Date Manufacturer Received01/18/2024
Was Device Evaluated by Manufacturer? Device Not Returned to Manufacturer
Date Device Manufactured08/25/2022
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Initial
Patient Sequence Number1
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