MAUDE Adverse Event Report: ALCON LABORATORIES IRELAND LTD. ACRYSOF IQ TORIC SINGLEPIECE IOL; LENS, INTRAOCULAR, TORIC OPTICS

Model Number SN6AT4

Device Problem Mechanical Problem (1384)

Patient Problem Blurred Vision (2137)

Event Date 04/22/2019

Event Type  Injury  

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.There have been no other complaints reported in the lot number.Additional information has been requested.(b)(4).

Event Description

A facility representative reported that three weeks following an intraocular lens (iol) implant procedure, the iol was exchanged for another lens due to blurred vision.The clinical reason given for the explant was "mechanical complication of iol." additional information has been requested.

Manufacturer Narrative

The manufacturer internal reference number is: (b)(4).

Event Description

Additional information was received indicating the toric marker was not lined up where it was planned to be, and the patient ending up with residual astigmatism.

• Brand Name: ACRYSOF IQ TORIC SINGLEPIECE IOL
• Type of Device: LENS, INTRAOCULAR, TORIC OPTICS
• Manufacturer (Section D): ALCON LABORATORIES IRELAND LTD.; cork business&technology park; model farm road; cork 00000 ; EI 00000
• MDR Report Key: 8666652
• MDR Text Key: 146946988
• Report Number: 9612169-2019-00132
• Device Sequence Number: 1
• Product Code: MJP
• Combination Product (y/n): N
• PMA/PMN Number: P930014
• Number of Events Reported: 1
• Summary Report (Y/N): N
• Report Source: Manufacturer
• Source Type: other
• Type of Report: Initial,Followup
• Report Date: 07/01/2019

1 Device was Involved in the Event

1 Patient was Involved in the Event

• Is this an Adverse Event Report?: Yes
• Is this a Product Problem Report?: Yes
• Device Operator: Health Professional
• Device Expiration Date: 05/31/2023
• Device Model Number: SN6AT4
• Device Catalogue Number: SN6AT4.200
• Device Lot Number: 21219953
• Was Device Available for Evaluation?: No
• Initial Date Manufacturer Received: 05/08/2019
• Initial Date FDA Received: 06/04/2019
• Supplement Dates Manufacturer Received: 06/04/2019
• Supplement Dates FDA Received: 07/01/2019
• Is This a Reprocessed and Reused Single-Use Device?: No
• Patient Sequence Number: 1
• Treatment: DISCOVISC OVD; MONARCH III D CARTRIDGE; MONARCH III INJECTOR
• Patient Outcome(s): Required Intervention
• Patient Age: 72 YR