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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ALCON RESEARCH, LLC - HUNTINGTON ACRYSOF IQ ASPHERIC UV ABSORBING IOLWITH ULTRASERT DELIVERY SYSTEM; LENS, GUIDE, INTRAOCULAR

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ALCON RESEARCH, LLC - HUNTINGTON ACRYSOF IQ ASPHERIC UV ABSORBING IOLWITH ULTRASERT DELIVERY SYSTEM; LENS, GUIDE, INTRAOCULAR Back to Search Results
Model Number ACU0T0
Device Problems Failure to Deliver (2338); Defective Device (2588)
Patient Problems Insufficient Information (4580); No Clinical Signs, Symptoms or Conditions (4582)
Event Date 04/21/2021
Event Type  malfunction  
Manufacturer Narrative
Evaluation summary: the product was not returned for analysis.The product history and batch records were reviewed and documentation indicated the product met release criteria.The product investigation could not identify a root cause.There have been no other complaints reported in the lot number.The manufacturer internal reference number is: (b)(4).
 
Event Description
A health professional reported that during an intraocular lens (iol) procedure, the plunger went over the top of both lenses and the haptics did not open out correctly.The lenses came into contact with the patient.Additional information has been requested.
 
Manufacturer Narrative
Additional information provided in b.3., b.5., d.9., and h.6.The manufacturer internal reference number is: (b)(4).
 
Event Description
Additional information has been received stating the surgery was completed after exchanging the device.There was no patient impact.
 
Manufacturer Narrative
Additional information provided in h.10.Product evaluation: the product was not returned.Viscoelastic was not provided.It is unknown if a qualified product was used.Root cause: it is unknown if a qualified viscoelastic was used.Material properties of non-qualified ovds may contribute to underfill, overfill, misfolding of the haptics, or other inconsistent folding outcomes.Plunger override may occur: ¿ due to rapid advancement faster than the dfu recommend rate.¿ if inadequate viscoelastic is placed in the device this will cause inadequate coverage of the lens fold path which may cause the lens to advance incorrectly or become ¿stuck¿ in the device allowing the plunger to override the lens.¿ if the device is overfilled with ovd, this can prevent the trailing haptic from being placed properly or move the lens out of position resulting in misfolding.¿ if the operating room temperature is too high (> 23°c / 73° f) lens folding consistency is negatively affected, the lens is more adherent and this may inhibit lens advancement.Any of the above listed causes alone, or in combination, may create the reported event.The manufacturer internal reference number is: (b)(4).
 
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Brand Name
ACRYSOF IQ ASPHERIC UV ABSORBING IOLWITH ULTRASERT DELIVERY SYSTEM
Type of Device
LENS, GUIDE, INTRAOCULAR
Manufacturer (Section D)
ALCON RESEARCH, LLC - HUNTINGTON
6065 kyle lane
huntington WV 25702
MDR Report Key11736892
MDR Text Key247713755
Report Number1119421-2021-00906
Device Sequence Number1
Product Code KYB
UDI-Device Identifier00380652395281
UDI-Public00380652395281
Combination Product (y/n)N
PMA/PMN Number
P930014
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type company representative,foreig
Type of Report Initial,Followup,Followup
Report Date 07/22/2021
1 Device was Involved in the Event
1 Patient was Involved in the Event
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Operator Health Professional
Device Expiration Date11/30/2021
Device Model NumberACU0T0
Device Lot Number12670660
Was Device Available for Evaluation? No
Initial Date Manufacturer Received 04/27/2021
Initial Date FDA Received04/28/2021
Supplement Dates Manufacturer Received04/29/2021
06/25/2021
Supplement Dates FDA Received05/06/2021
07/22/2021
Is This a Reprocessed and Reused Single-Use Device? No
Patient Sequence Number1
Treatment
PROVISC
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