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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: AMO PUERTO RICO MFG. INC. SENSAR IOL; INTRAOCULAR LENS

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AMO PUERTO RICO MFG. INC. SENSAR IOL; INTRAOCULAR LENS Back to Search Results
Model Number AR40E
Medical Device Problem Codes Break (1069); Use of Device Problem (1670)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 05/02/2025
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that an monofocal intraocular lens (iol) had a loading issue and the haptic broke during insertion.The lens was in the patient's right eye.Through follow up, it was learned that the trailing haptic broke during insertion.The iol was removed, cut, and replaced during the same procedure.Another johnson & johnson lens (same model and diopter) was implanted as a replacement with no issues.There was no patient injury.There was no medical or surgical intervention outside of the standard care.It was reported that the patient needed a retinal surgery related to the surgical complications and not the lens insertion.The iol is not available for return.No other information was provided.
 
Additional Manufacturer Narrative
Section a5: ethnicity: unknown/asked but not provided.Section d6a: if implanted, give date: not applicable, as lens was removed/replaced during the same procedure.Section d6b: if explanted, give date: not applicable, as lens was removed/replaced during the same procedure.Section e1: telephone number: (b)(6).Section h3: the device was not returned for evaluation; therefore, a failure analysis of the complaint device cannot be completed.A review of the device history record, complaint trending, for this device will be performed.Upon completion of the review, if there is any further relevant information a supplemental medwatch will be filed.An attempt has been made to obtain missing information.However, the account did not provide the information.All pertinent information available to johnson and johnson surgical vision, inc.Has been submitted.
 
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Brand Name
SENSAR IOL
Common Device Name
INTRAOCULAR LENS
Manufacturer (Section D)
AMO PUERTO RICO MFG. INC.
road 402 north, anasco ind. pk
anasco PR 00610
Manufacturer Contact
somyata nagpal
31 technology drive
irvine, CA 92618
7142478552
MDR Report Key22154414
Report Number3012236936-2025-000155
Device Sequence Number9208994
Product Code HQL
UDI-Device Identifier05050474502079
UDI-Public(01)05050474502079(17)290321
Combination Product (Y/N)N
Initial Reporter CountryCA
PMA/510(K) Number
P980040
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)N
Reporter Type Manufacturer
Report Source Foreign,Consumer,Health Professional
Initial Reporter Occupation Non-Healthcare Professional
Type of Report Initial
Report Date (Section B) 06/05/2025
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
Operator of Device Health Professional
Device Model NumberAR40E
Device Catalogue NumberAR40E00185
Was Device Available for Evaluation? No
Was the Report Sent to FDA? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 05/08/2025
Initial Report FDA Received Date06/05/2025
Was Device Evaluated by Manufacturer? (Y/N) No
Date Device Manufactured03/21/2024
Is the Device Labeled for Single Use? (Y/N) Yes
Is This a Single-Use Device that was
Reprocessed and Reused on a Patient? (Y/N)
No
Usage of Device Initial
Patient Sequence Number1
Patient SexMale
Patient Weight57 KG
Patient RaceAsian
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