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Additional information has been provided in d.9., h.3., h.6., and h.11.The device with the lens was returned.The plunger lock and lens stop have been removed.The plunger was oriented correctly.Inadequate viscoelastic was observed in the device.No viscoelastic was observed in the tip of the nozzle of the device.Viscoelastic was only observed on/at the area of the lens.The plunger and lens were advanced to mid-nozzle.The leading haptic was extended towards the nozzle tip.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.A non-qualified viscoelastic was indicated.A straight leading haptic was observed and may have been interpreted as the reported complaint.In addition, an inadequate amount of a non-qualified viscoelastic was observed in the device.No viscoelastic was observed in the tip of the nozzle of the device.Viscoelastic was only observed on/at the area of the lens.The ifu (instruction for use) instructs: fill the device until viscoelastic can be observed flowing to the line on the nozzle tip.This will require approximately 0.2 ml of viscoelastic.If inadequate viscoelastic is placed in the device this will cause inadequate coverage of the lens fold path which may cause the lens to advance incorrectly or become ¿stuck¿ in the device.Only use an company ovd (ophthalmic viscosurgical device) qualified for use with the company pre-loaded delivery system that has been allowed to come to the operating room temperature.Straight leading haptics are not a product malfunction.This is an acceptable position per the diagrams provided in the ifu.A straight leading haptic may occur: ¿ due to the normal folding variations as indicated in the ifu diagrams.¿ if the initial plunger advancement is faster than the recommended target, the leading haptic may be forced past the internal folding feature.¿ if there is excessive delay between the device preparation and subsequent delivery the leading haptic may start to unfold.¿ due to the use of a non-qualified viscoelastic.Material properties of non-qualified ovds may contribute to underfill, overfill, misfolding of the haptics, or other inconsistent folding outcomes.¿ if the operating room temperature is too high (> 23°c / 73° f) lens folding consistency is negatively affected, the lens is more adherent and this may inhibit lens advancement or contribute to incorrect haptic folding.Any of the above listed causes alone, or in combination, may create the reported event.The ifu instructs: insert the tip of the cartridge through the incision.Position the tip at the anterior capsule opening.If the leading haptic is looped or straight in front of the optic, rotate the nozzle clockwise as needed to be bevel left to facilitate placement of the leading haptic into its normal orientation in the bag.Slowly advance the lens until the optic is exiting the nozzle.Rotate the cartridge counter-clockwise towards bevel right as needed to place the lens anterior side up.The manufacturer internal reference number is: (b)(4).
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