| Brand Name | ENVISTA TORIC INTRAOCULAR LENS |
| Common Device Name | LENS, INTRAOCULAR, TORIC OPTICS |
| Manufacturer (Section D) |
| BAUSCH + LOMB INC. |
| 1400 north goodman street |
| rochester NY 14609 |
|
| Manufacturer (Section G) |
| BAUSCH + LOMB, INC |
| 21 north park place blvd. |
|
| clearwater FL 33759 |
|
| Manufacturer Contact |
|
shayan
habibi
|
| 21 north park place blvd. |
| clearwater, FL 33759
|
|
7277246600
|
|
| MDR Report Key | 21896629 |
| Report Number | 0001313525-2025-00088 |
| Device Sequence Number | 19693515 |
| Product Code |
MJP
|
| UDI-Device Identifier | 10757770611604 |
| UDI-Public | (01)10757770611604(17)271031(11)241125(10)3Q32333 |
| Combination Product (Y/N) | N |
| Initial Reporter State | PA |
| Initial Reporter Country | US |
| PMA/510(K) Number | P910056 |
| Number of Events Summarized | 1 |
| Summary Report (Y/N) | N |
| Device Implanted Year | 2025 |
| Serviced by Third Party (Y/N) | Unknown |
| Reporter Type |
Manufacturer
|
| Report Source |
Health Professional,User Facility,Company Representative |
| Initial Reporter Occupation |
Physician
|
| Remedial Action |
Recall |
| Type of Report
| Initial |
| Report Date (Section B) |
04/01/2025 |
| 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 Number | ETE |
| Device Catalogue Number | ETEU150+155 |
| Device Lot Number | 3Q32333 |
| Was Device Available for Evaluation? |
No
|
| Is the Reporter a Health Professional? |
Yes
|
| Type of Report(Section G) | Thirty-Day |
| Initial Date Received by Manufacturer | 04/15/2025 |
| Initial Report FDA Received Date | 04/23/2025 |
| Was Device Evaluated by Manufacturer? (Y/N) |
Yes
|
| Date Device Manufactured | 11/25/2024 |
| Is the Device Labeled for Single Use? (Y/N) |
No
|
Is This a Single-Use Device that was Reprocessed and Reused on a Patient? (Y/N) |
No
|
| Usage of Device |
Initial
|
If action reported to FDA under 21 USC 360i(g), list FDA-assigned Recall Number or include a statement | RES96594 |
| Patient Sequence Number | 1 |
Concomitant Medical Products and Therapy/Usage Dates | BLIS-R1, BLIS-X1 |
| Outcome Attributed to Adverse Event |
Required Intervention;
|
| Patient Age | 71 YR |
| Patient Sex | Female |
|
|