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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 Contamination (1120)
Patient Problem No Clinical Signs, Symptoms or Conditions (4582)
Event Date 10/21/2021
Event Type  malfunction  
Event Description
A physician reported that during an intraocular lens (iol0 implant procedure, there was a residue on the lenses occurring with all company lenses that are being used through a company cartridge and does not resolve when using different viscoelastic.The reporter guess was that was some sort of oil based material originating in the cartridge.The surgeon states that the residue is on the posterior side of the lens, and is not easy to irrigate/aspirate (i/a) the material off the lens.They have to manually scrape the material off with a metal instrument in order to fully remove it.Another important note is that the residue does not occur when they are using preloaded lenses.
 
Manufacturer Narrative
A sample device was not returned for analysis.Complaint history and product history record could not be reviewed because the reporting facility did not provide a valid lot number or any identification traceable to the manufacturing documentation.Root cause has not been identified.The manufacturer internal reference number is: (b)(4).
 
Manufacturer Narrative
Additional information provided in d.9., h.3., h.6.And h.10.A photo was provided of what appears to be a single-piece monofocal lens in the eye.There appears to be a linear strip of foreign material on the posterior surface of the lens.A determination as to the nature and origin of the material cannot be made from the photo.Appears to be the same lens as pictured in pr1879309.Requested clarification due to similarities for possible duplicated complaint.Associated products were not provided.It is unknown if qualified products are being used.The product investigation could not identify a root cause for the reported complaint.The product was not returned for evaluation.No determination can be made without physical evaluation of the complaint sample.A photo was provided.There appears to be a linear strip of material on the posterior surface of the lens.A determination as to the nature and origin of the material cannot be made from the photo.Not enough information was provided by the reporter for further investigation.It is unknown if a qualified lens model/diopter, handpiece and viscoelastic were used.Per the ifu: the company device iol delivery system is for implantation of qualified company foldable iols.No unqualified lenses should be used with the company device iol delivery system.The company device cartridges are qualified for use with compatible company device handpieces for the surgical implantation of company qualified foldable iols.Company foldable iols are qualified for use with an company qualified delivery system (handpiece and cartridge) and ophthalmic viscosurgical device (ovd) combination.The use of an unqualified combination may cause damage to the iol and potential complications during the implantation process.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 Key12789642
MDR Text Key280785277
Report Number1119421-2021-02100
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 Physician
Type of Report Initial,Followup
Report Date 02/07/2022
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 Catalogue Number8065977763
Device Lot NumberASKU
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer01/07/2022
Is the Reporter a Health Professional? Yes
Initial Date Manufacturer Received 10/22/2021
Initial Date FDA Received11/10/2021
Supplement Dates Manufacturer Received01/11/2022
Supplement Dates FDA Received02/07/2022
Was Device Evaluated by Manufacturer? Device Not Returned to Manufacturer
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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