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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 Device Damaged by Another Device (2915)
Patient Problem No Clinical Signs, Symptoms or Conditions (4582)
Event Date 11/08/2023
Event Type  malfunction  
Manufacturer Narrative
A sample device was not returned for analysis.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).
 
Event Description
A non-healthcare professional reported that during the cataract surgery with intraocular lens (iol) implant procedure scratch on lens noticed after lens had been inserted.Iol left in place.Once lens inserted into the eye, the surgeon noticed a scratch on the iol in the cartridge.There was no patient harm reported.
 
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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 Key18301196
MDR Text Key330169720
Report Number1119421-2023-02130
Device Sequence Number1
Product Code MSS
UDI-Device Identifier00380659777639
UDI-Public00380659777639
Combination Product (y/n)N
Reporter Country CodeUK
PMA/PMN Number
K063155
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Foreign
Reporter Occupation Non-Healthcare Professional
Type of Report Initial
Report Date 12/11/2023
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 Catalogue Number8065977763
Device Lot Number15666794
Was Device Available for Evaluation? No
Initial Date Manufacturer Received 11/16/2023
Initial Date FDA Received12/11/2023
Was Device Evaluated by Manufacturer? Device Not Returned to Manufacturer
Date Device Manufactured06/14/2023
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Initial
Patient Sequence Number1
Treatment
ACRYSOF IQ TORIC SINGLEPIECE IOL
Patient Age63 YR
Patient SexFemale
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