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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ALCON RESEARCH, LLC - HUNTINGTON MONARCH III IOL DELIVERY SYSTEM, CARTRIDGE D; FOLDERS AND INJECTORS, INTRAOCULAR LENS (IOL)

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ALCON RESEARCH, LLC - HUNTINGTON MONARCH III IOL DELIVERY SYSTEM, CARTRIDGE D; FOLDERS AND INJECTORS, INTRAOCULAR LENS (IOL) Back to Search Results
Catalog Number 8065977763
Device Problem Scratched Material (3020)
Patient Problem Insufficient Information (4580)
Event Date 09/11/2023
Event Type  malfunction  
Event Description
A nurse reported during an intraocular lens (iol) implant procedure, the surgeon determined that a scratch had occurred, likely caused by the cartridge used.The scratch was located at the periphery of the lens and was deemed not to be visually significant, the intraocular lens was left in place, additional information was requested.
 
Manufacturer Narrative
The product was not returned for analysis; the lens remains implanted.Complaint history and product history records were reviewed and documentation indicated the product met release criteria.Root cause has not been identified.The manufacturer internal reference number is: (b)(4).
 
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Brand Name
MONARCH III IOL DELIVERY SYSTEM, CARTRIDGE D
Type of Device
FOLDERS AND INJECTORS, INTRAOCULAR LENS (IOL)
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 Key17948588
MDR Text Key325805258
Report Number1119421-2023-01768
Device Sequence Number1
Product Code MSS
UDI-Device Identifier00380659777639
UDI-Public00380659777639
Combination Product (y/n)N
Reporter Country CodeUS
PMA/PMN Number
K063155
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Health Professional,Company Representative
Reporter Occupation Nurse
Type of Report Initial
Report Date 10/17/2023
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received10/17/2023
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Operator Health Professional
Device Catalogue Number8065977763
Device Lot Number15675991
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Date Manufacturer Received09/20/2023
Was Device Evaluated by Manufacturer? Device Not Returned to Manufacturer
Date Device Manufactured06/28/2023
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Initial
Patient Sequence Number1
Treatment
IOL, UNSPECIFIED
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