| Brand Name | ACRYSOF MULTIPIECE IOL |
| Common Device Name | INTRAOCULAR LENS |
| Manufacturer (Section D) |
| ALCON RESEARCH, LLC - HUNTINGTON |
| 246 kyle lane |
| huntington WV 25702 |
|
| Manufacturer (Section G) |
| ALCON RESEARCH, LLC - HUNTINGTON |
| 246 kyle lane |
|
| huntington WV 25702 |
|
| Manufacturer Contact |
|
jonathan
schlech
|
| 6201 south freeway |
| mail stop ab2-6 |
| fort worth, TX 76134
|
|
8007579780
|
|
| MDR Report Key | 23279684 |
| Report Number | 1119421-2025-02683 |
| Device Sequence Number | 18333485 |
| Product Code |
HQL
|
| UDI-Device Identifier | 00380652552554 |
| UDI-Public | (01)00380652552554(17)290421(11)240423(10)15823782 |
| Combination Product (Y/N) | N |
| Initial Reporter Country | BG |
| PMA/510(K) Number | P930014 |
| Number of Events Summarized | 1 |
| Summary Report (Y/N) | N |
| Reporter Type |
Manufacturer
|
| Report Source |
Foreign,Health Professional,Company Representative |
| Initial Reporter Occupation |
Other Health Care Professional
|
| Type of Report
| Initial |
| Report Date (Section B) |
10/13/2025 |
| 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 Number | MA60AC |
| Device Catalogue Number | MA60AC.215 |
| Device Lot Number | 15823782 |
| Was Device Available for Evaluation? |
No
|
| Is the Reporter a Health Professional? |
Yes
|
| Type of Report(Section G) | Initial |
| Initial Date Received by Manufacturer | 09/19/2025 |
| Initial Report FDA Received Date | 10/15/2025 |
| Date Device Manufactured | 04/23/2024 |
Is This a Single-Use Device that was Reprocessed and Reused on a Patient? (Y/N) |
No
|
| Usage of Device |
Initial
|
| Patient Sequence Number | 1 |
Concomitant Medical Products and Therapy/Usage Dates | MONARCH II LOADING FORCEPS.; MONARCH III IOL DELIVERY SYSTEM, INJECTOR.; MONARCH IOL DELIVERY SYSTEM, CARTRIDGE.; UNSPECIFIED REPLACEMENT LENS.; VISCOAT OPHTHALMIC VISCOSURGICAL DEVICE. |
| Patient Age | 48 YR |
| Patient Sex | Male |