| Brand Name | ACRYSOF IQ SINGLEPIECE IOL WITH ULTRASERT DELIVERY SYSTEM |
| Common Device Name | LENS, GUIDE, INTRAOCULAR |
| 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 | 25227375 |
| Report Number | 1119421-2026-01085 |
| Device Sequence Number | 10001133 |
| Product Code |
KYB
|
| UDI-Device Identifier | 00380652394789 |
| UDI-Public | (01)00380652394789(17)281118(11)251120(10)16161117 |
| Combination Product (Y/N) | N |
| Initial Reporter Country | GM |
| PMA/510(K) Number | P930014 |
| Number of Events Summarized | 1 |
| Summary Report (Y/N) | N |
| Reporter Type |
Manufacturer
|
| Report Source |
Foreign,Health Professional |
| Initial Reporter Occupation |
Other Health Care Professional
|
| Type of Report
| Initial |
| Report Date (Section B) |
05/20/2026 |
| 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 Number | AU00T0 |
| Device Lot Number | 16161117 |
| Was Device Available for Evaluation? |
No
|
| Is the Reporter a Health Professional? |
Yes
|
| Type of Report(Section G) | Initial |
| Initial Date Received by Manufacturer | 04/23/2026 |
| Initial Report FDA Received Date | 05/20/2026 |
| Date Device Manufactured | 11/20/2025 |
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 |
| Patient Sex | Unknown |
|
|