|
A nurse reported that during an intraocular lens (iol) implant procedure, during lens loading, the lens failed to exit the cartridge, indicating a defect.The product was replaced with a new one, and the surgery was safely completed without any harm to the patient.
|
|
Additional information has been provided in d.9., h.3., h.6., h.11.The lens was not returned stuck in a cartridge as described.The lens was returned positioned incorrectly posterior side up in the lens case, which caused damage to the lens.Solution was dried on the lens.Both haptics were folded and bent in the gusset and distal area.The optic was pressed against the posts and down into the well area of the lens case.The associated cartridge was not returned for evaluation.A device history record review and a non-conformance review of the reported lot number was conducted.The deviation review did not reveal any potential contributing factors to the reported complaint and all corresponding production release specifications defined in the device master record were met.The file indicated the use of qualified associated products.The reported lens stuck complaint could not be confirmed.The lens was not returned stuck in a cartridge as described.The cartridge was not returned for evaluation.The lens was returned positioned incorrectly in the lens case which caused damage to the lens.All lenses are 100% inspected for cosmetic attributes and the damage exhibited by the returned complaint sample would not have met company¿s release criteria.Based on our observation, and the review of manufacturing records, it can be reasonably concluded that the damage is not manufacturing related.The file indicated the use of qualified associated products.The ifu instructs to completely fill the cartridge with ovd immediately prior to loading and delivery of the lens.Do not attempt to load the lens without adequate ovd in the device.Not adequately filling the device with viscoelastic will result in inadequate coverage of lens and the lens fold path with ovd, which may result in damage.The ifu instructs: using holding forceps, grasp the lens by the optic edge and gently place the lens anterior side up into the back of the ovd-filled cartridge.The lens should be inserted until the optic is a little more than half-way inside the cartridge.Use the holding forceps to gently push down on the lens, verifying that the lens is on the bottom surface of the cartridge.Using holding forceps, take the trailing haptic, and gently fold the haptic onto the anterior side of the optic.Slowly grip or push the optic edge to position the lens as far into the cartridge as the forceps will permit, while ensuring the lens remains on the bottom surface of the cartridge and the trailing haptic remains on the optic.Failure to follow these steps may cause the lens to advance incorrectly causing delivery issues and/or damage.The manufacturer internal reference number is: (b)(4).
|