Brand Name | SOFPORT AO INTRAOCULAR LENS |
Type of Device | INTRAOCULAR LENS |
Manufacturer (Section D) |
BAUSCH + LOMB |
rochester NY 14609 |
|
Manufacturer (Section G) |
BAUSCH + LOMB |
21 north park place blvd. |
|
clearwater FL 33759 |
|
Manufacturer Contact |
shayan
habibi
|
21 north park place blvd. |
clearwater, FL 33759
|
7277246600
|
|
MDR Report Key | 16042553 |
MDR Text Key | 306075936 |
Report Number | 0001313525-2022-00190 |
Device Sequence Number | 1 |
Product Code |
HQL
|
UDI-Device Identifier | 10757770474216 |
UDI-Public | (01)10757770474216(17)250131 |
Combination Product (y/n) | N |
Reporter Country Code | US |
PMA/PMN Number | P910061 |
Number of Events Reported | 1 |
Summary Report (Y/N) | N |
Report Source |
Manufacturer
|
Source Type |
Consumer,Health Professional |
Reporter Occupation |
Non-Healthcare Professional
|
Type of Report
| Initial,Followup,Followup |
Report Date |
11/28/2022 |
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? |
No
|
Device Operator |
Health Professional
|
Device Model Number | LI61AO |
Device Catalogue Number | LI61AOR1500 |
Device Lot Number | 4041711 |
Was Device Available for Evaluation? |
No
|
Initial Date Manufacturer Received |
Not provided |
Initial Date FDA Received | 12/23/2022 |
Supplement Dates Manufacturer Received | Not provided Not provided
|
Supplement Dates FDA Received | 03/08/2023 03/27/2023
|
Was Device Evaluated by Manufacturer? |
Device Not Returned to Manufacturer
|
Date Device Manufactured | 02/13/2020 |
Is the Device Single Use? |
Yes
|
Is This a Reprocessed and Reused Single-Use Device? |
No
|
Type of Device Usage |
Initial
|
Patient Sequence Number | 1 |
Treatment | EASY LOAD INJECTOR.PROVISC. |
Patient Outcome(s) |
Required Intervention;
|
Patient Age | 62 YR |
Patient Sex | Male |