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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: JOHNSON & JOHNSON SURGICAL VISION, INC. SENSAR; MONOFOCAL IOLS

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JOHNSON & JOHNSON SURGICAL VISION, INC. SENSAR; MONOFOCAL IOLS Back to Search Results
Model Number AR40E
Device Problem Break (1069)
Patient Problems Vitrectomy (2643); No Code Available (3191)
Event Date 10/22/2020
Event Type  Injury  
Manufacturer Narrative
If implanted: not applicable, as the intraocular lens was inserted and removed in the initial surgery.If explanted: not applicable, as the intraocular lens was inserted and removed in the initial surgery.(b)(4).All pertinent information available to johnson & johnson surgical vision, inc.Has been submitted.
 
Event Description
It was reported that a model ar40e intraocular lens (iol) was partially inserted into the patient's right eye and then removed due to a broken haptic inside the eye.A vitrectomy, sutures, and incision enlargement were required.No patient injury was reported.The replacement lens is the same lens model and diopter.No further information is available.
 
Manufacturer Narrative
Device available for evaluation? yes returned to manufacturer on: 1/6/2021 device returned to manufacturer? yes device evaluation: visual inspection under magnification revealed viscoelastic residue on the optic body and remaining haptic and that the lens was returned cut (but not separated), which is consistent with a lens that was handled during removal and replacement.Furthermore, a detached haptic (not returned) and a damaged haptic with missing material were observed.Dimensional inspection could not be performed because returned haptic was damaged, the other haptic was detached, and the drill hole was returned with a customer handled lens.¿dc-haptic damaged¿ was confirmed, however per the initial report the ¿broken haptic¿ was observed during handling for insertion, and therefore cannot be confirmed to be related to manufacturing and no product deficiency could be identified.Manufacturing record review: the manufacturing process record was evaluated and revealed that the product was manufactured and released according to specifications.A search revealed that no other complaints were received from this production order.Conclusion: as a result of the investigation there is no indication of a product quality deficiency and the reported issue could not be verified.All pertinent information available to johnson & johnson surgical vision, inc.Has been submitted.
 
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Brand Name
SENSAR
Type of Device
MONOFOCAL IOLS
Manufacturer (Section D)
JOHNSON & JOHNSON SURGICAL VISION, INC.
1700 e st andrew place
santa ana CA 92705
MDR Report Key11061670
MDR Text Key223374155
Report Number2648035-2020-00957
Device Sequence Number1
Product Code HQL
UDI-Device Identifier05050474502055
UDI-Public(01)05050474502055(17)240301
Combination Product (y/n)Y
PMA/PMN Number
P980040
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type health professional,user faci
Type of Report Initial,Followup
Report Date 02/24/2021
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received12/22/2020
Is this an Adverse Event Report? Yes
Is this a Product Problem Report? Yes
Device Operator Health Professional
Device Expiration Date03/01/2024
Device Model NumberAR40E
Device Catalogue NumberAR40E00175
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer01/06/2021
Date Manufacturer Received01/31/2021
Is This a Reprocessed and Reused Single-Use Device? No
Patient Sequence Number1
Treatment
CARTRIDGE MODEL NOT PROVIDED; CARTRIDGE MODEL NOT PROVIDED
Patient Outcome(s) Required Intervention;
Patient Age47 YR
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