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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: AMO PUERTO RICO MFG. INC. UNFOLDER PLATINUM 1 SERIES; LENS, GUIDE, INTRAOCULAR

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AMO PUERTO RICO MFG. INC. UNFOLDER PLATINUM 1 SERIES; LENS, GUIDE, INTRAOCULAR Back to Search Results
Model Number 1MTEC30
Medical Device Problem Code Crack (1135)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 04/10/2026
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
Section a3b, a4, a5 and a6: unknown, information not provided.Section d6a: if implanted, give date: not applicable, as the product is not an implantable device section d6b: if explanted, give date: not applicable, as the product is not an implantable device section e1: initial reporter: email address: unknown, information not provided.Section e1: initial reporter: 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 and complaint history for production order for this device will be performed.Upon completion of the review, if there is any further relevant information a supplemental medwatch will be filed.All pertinent information available to johnson & johnson surgical vision, inc.Has been submitted.
 
Event or Problem Description
It was reported that during implantation of the intraocular lens (iol), the front portion of the iol cartridge was found to be broken.The operation was immediately stopped, a qualified iol folding forceps was used to replace it, the surgery proceeded smoothly, and no harm was caused to the patient.No further information was provided.
 
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Brand Name
UNFOLDER PLATINUM 1 SERIES
Common Device Name
LENS, GUIDE, INTRAOCULAR
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 Key25162961
Report Number3012236936-2026-000128
Device Sequence Number12920188
Product Code KYB
UDI-Device Identifier05050474540323
UDI-Public(01)05050474540323(17)261117(10)CA51613
Combination Product (Y/N)N
Initial Reporter CountryCH
PMA/510(K) Number
K081545
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)N
Reporter Type Manufacturer
Report Source Foreign,Health Professional,User Facility,Company Representative
Initial Reporter Occupation Non-Healthcare Professional
Type of Report Initial
Report Date (Section B) 05/13/2026
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 Number1MTEC30
Device Catalogue Number1MTEC30
Device Lot NumberCA51613
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 04/16/2026
Initial Report FDA Received Date05/13/2026
Was Device Evaluated by Manufacturer? (Y/N) No
Date Device Manufactured11/17/2025
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 Number1
Patient Age56 YR
Patient SexMale
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