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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ALCON RESEARCH, LLC - HUNTINGTON ACRYSOF MULTIPIECE IOL; INTRAOCULAR LENS

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ALCON RESEARCH, LLC - HUNTINGTON ACRYSOF MULTIPIECE IOL; INTRAOCULAR LENS Back to Search Results
Model Number MA60AC
Device Problems Defective Component (2292); Device Dislodged or Dislocated (2923)
Patient Problems Headache (1880); Eye Pain (4467)
Event Date 08/30/2023
Event Type  malfunction  
Manufacturer Narrative
The product was returned for analysis.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 facility representative reported that following an intraocular lens (iol) implant procedure, findings on both follow up visits showed well centered iol, clear cornea & corneal suture in place on operated eye.The patient came with complain of head ache and pain on the operated eye.After the examination, the surgeon found out that the haptic slipped from the junction on optic.Additional information has been requested, received and stated explant was planned.
 
Manufacturer Narrative
The product was not returned.Product history records were reviewed and documentation indicated the product met release criteria.A non-company viscoelastic was indicated.A cartridge and handpiece were not indicated.It is unknown if a delivery system was used or if the lens was manually implanted.The product investigation could not identify a root cause for the reported complaint.A determination cannot be made without physical examination of the product.The company 30.0 diopter lens is qualified for use with the company cartridges.The instruction for use (ifu) instructs that a company qualified delivery system and viscoelastic combination should be used.The use of an unqualified combination may cause damage to the lens and potential complications during the implantation process.The reporter has not responded to the follow up requests.The file will be reopened if the sample or new information is received.The manufacturer internal reference number is: (b)(4).
 
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Brand Name
ACRYSOF MULTIPIECE IOL
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 Key17874832
MDR Text Key324961566
Report Number1119421-2023-01708
Device Sequence Number1
Product Code HQL
UDI-Device Identifier00380652552721
UDI-Public00380652552721
Combination Product (y/n)N
Reporter Country CodeSA
PMA/PMN Number
P930014
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Foreign,Health Professional,Company Representative,Distributor
Reporter Occupation Nurse
Type of Report Initial,Followup
Report Date 11/10/2023
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received10/05/2023
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Operator Health Professional
Device Model NumberMA60AC
Device Catalogue NumberMA60AC.300
Device Lot Number15505334
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Date Manufacturer Received10/17/2023
Was Device Evaluated by Manufacturer? Device Not Returned to Manufacturer
Date Device Manufactured10/03/2022
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Initial
Patient Sequence Number1
Treatment
OPHLINE 2%
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