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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ALCON RESEARCH, LLC - HUNTINGTON CLAREON VIVITY EXTENDED VISION UV ABSORBING IOL; EXTENDED DEPTH OF FOCUS INTRAOCULAR LENS

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ALCON RESEARCH, LLC - HUNTINGTON CLAREON VIVITY EXTENDED VISION UV ABSORBING IOL; EXTENDED DEPTH OF FOCUS INTRAOCULAR LENS Back to Search Results
Model Number CCWET0
Medical Device Problem Code Adverse Event Without Identified Device or Use Problem (2993)
Health Effect - Clinical Code Blurred Vision (2137)
Date of Event 08/09/2024
Type of Reportable Event Serious Injury
Additional Manufacturer Narrative
The product was not returned for analysis; the lens remains implanted.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).H.10 reflects all related report numbers associated with this product event that have been submitted at this time.
 
Event or Problem Description
A consumer reported that following an intraocular lens (iol) implant procedure, he cannot read print without reading glasses.He has spoken with doctor regarding this, she prescribed reading glasses.He would like company to reach out to the surgeon for further information of his outcome.Additional information received; the cause of event was limitation of extended depth of focus technology.There was no patient harm.There are two medical device reports associated with this patient.This report is associated with the right eye.
 
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Brand Name
CLAREON VIVITY EXTENDED VISION UV ABSORBING IOL
Common Device Name
EXTENDED DEPTH OF FOCUS INTRAOCULAR LENS
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 Key20557137
Report Number1119421-2024-02113
Device Sequence Number8885871
Product Code POE
UDI-Device Identifier00380652405782
UDI-Public(01)00380652405782(17)271114(11)231116(10)15744791
Combination Product (Y/N)N
Initial Reporter StateIL
Initial Reporter CountryUS
PMA/510(K) Number
P190018
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2024
Reporter Type Manufacturer
Report Source Consumer
Initial Reporter Occupation Non-Healthcare Professional
Type of Report Initial
Report Date (Section B) 10/29/2024
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
Operator of Device Health Professional
Device Model NumberCCWET0
Device Catalogue NumberCCWET0.205
Device Lot Number15744791
Was Device Available for Evaluation? No
Type of Report(Section G)Initial
Initial Date Received by Manufacturer 09/30/2024
Initial Report FDA Received Date10/29/2024
Date Device Manufactured11/16/2023
Is This a Single-Use Device that was
Reprocessed and Reused on a Patient? (Y/N)
No
Usage of Device Initial
Patient Sequence Number1
Concomitant Medical Products
and Therapy/Usage Dates
CLAREON MONARCH IV IOL DELIVERY SYSTEM, INJECTOR.; MONARCH III IOL DELIVERY SYSTEM, CARTRIDGE D.; PROVISC OPHTHALMIC VISCOSURGICAL DEVICE.
Outcome Attributed to Adverse Event Other;
Patient Age82 YR
Patient SexMale
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