Brand Name | CLAREON MONARCH IV IOL DELIVERY SYSTEM, INJECTOR |
Type of Device | FOLDERS AND INJECTORS , INRAOCULAR LENS (IOL) |
Manufacturer (Section D) |
ALCON RESEARCH, LLC - ALCON PRECISION DEVICE |
714 columbia avenue |
sinking spring PA 19608 |
|
Manufacturer (Section G) |
ALCON RESEARCH, LLC - ALCON PRECISION DEVICE |
714 columbia avenue |
|
sinking spring PA 19608 |
|
Manufacturer Contact |
jonathan
schlech
|
6201 south freeway |
mail stop ab2-6 |
fort worth, TX 76134
|
8007579780
|
|
MDR Report Key | 17894906 |
MDR Text Key | 325251609 |
Report Number | 2523835-2023-00518 |
Device Sequence Number | 1 |
Product Code |
MSS
|
UDI-Device Identifier | 00380659777745 |
UDI-Public | 00380659777745 |
Combination Product (y/n) | N |
Reporter Country Code | NC |
PMA/PMN Number | K212039 |
Number of Events Reported | 1 |
Summary Report (Y/N) | N |
Report Source |
Manufacturer
|
Source Type |
Foreign,Health Professional |
Reporter Occupation |
Other Health Care Professional
|
Type of Report
| Initial,Followup |
Report Date |
12/29/2023 |
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 Model Number | IV |
Device Catalogue Number | 8065977774 |
Device Lot Number | ASKU |
Was Device Available for Evaluation? |
No
|
Is the Reporter a Health Professional? |
Yes
|
Initial Date Manufacturer Received |
09/14/2023
|
Initial Date FDA Received | 10/09/2023 |
Supplement Dates Manufacturer Received | 12/09/2023
|
Supplement Dates FDA Received | 12/29/2023
|
Was Device Evaluated by Manufacturer? |
Device Not Returned to Manufacturer
|
Is This a Reprocessed and Reused Single-Use Device? |
No
|
Type of Device Usage |
Reuse
|
Patient Sequence Number | 1 |
Treatment | PROVISC OPHTHALMIC VISCO SURGICAL DEVICE |