| Brand Name | ITRACK ADVANCE |
| Common Device Name | CANALOPLASTY MICROCATHETER KIT WITH ADVANCED DELIVERY SYSTEM |
| Manufacturer (Section D) |
| NOVA EYE, INC. |
| 41316 christy street |
| fremont CA 94538 |
|
| Manufacturer (Section G) |
| NOVA EYE, INC. |
| 41316 christy street |
|
| fremont CA 94538 |
|
| Manufacturer Contact |
|
don
watton
|
| 41316 christy street |
| fremont, CA 94538
|
|
5102911305
|
|
| MDR Report Key | 24254222 |
| Report Number | 3005641545-2026-00002 |
| Device Sequence Number | 9593230 |
| Product Code |
MPA
|
| UDI-Device Identifier | 00893872001622 |
| UDI-Public | 00893872001622 |
| Combination Product (Y/N) | N |
| Initial Reporter State | OH |
| Initial Reporter Country | US |
| PMA/510(K) Number | K221872 |
| Number of Events Summarized | 1 |
| Summary Report (Y/N) | N |
| Serviced by Third Party (Y/N) | N |
| Reporter Type |
Manufacturer
|
| Report Source |
Health Professional,User Facility,Company Representative |
| Initial Reporter Occupation |
Other Health Care Professional
|
| Type of Report
| Initial |
| Report Date (Section B) |
02/03/2026 |
| 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 | ITRACK-ADS |
| Device Catalogue Number | 203000-0001 |
| Device Lot Number | 2510-20 |
| 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 | 01/09/2026 |
| Initial Report FDA Received Date | 02/03/2026 |
| Was Device Evaluated by Manufacturer? (Y/N) |
No
|
| Date Device Manufactured | 10/01/2025 |
| 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 Number | 1 |
| Outcome Attributed to Adverse Event |
Required Intervention;
|
| Patient Sex | Unknown |