| Brand Name | MONARCH III IOL DELIVERY SYSTEM, CARTRIDGE D |
| Common Device Name | FOLDERS AND INJECTORS, INTRAOCULAR LENS (IOL) |
| 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 | 25360424 |
| Report Number | 1119421-2026-01178 |
| Device Sequence Number | 21502644 |
| Product Code |
MSS
|
| UDI-Device Identifier | 00380659777639 |
| UDI-Public | (01)00380659777639(17)290216(11)260218(10)16210520 |
| Combination Product (Y/N) | N |
| Initial Reporter State | IN |
| Initial Reporter Country | US |
| PMA/510(K) Number | K063155 |
| Number of Events Summarized | 1 |
| Summary Report (Y/N) | N |
| Reporter Type |
Manufacturer
|
| Report Source |
Health Professional,Company Representative |
| Initial Reporter Occupation |
Physician
|
| Type of Report
| Initial,Followup |
| Report Date (Section B) |
06/26/2026 |
| 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 Catalogue Number | 8065977763 |
| Device Lot Number | 16210520 |
| Was Device Available for Evaluation? |
Device Returned to Manufacturer
|
| Date Returned to Manufacturer | 05/27/2026 |
| Is the Reporter a Health Professional? |
Yes
|
| Type of Report(Section G) | Follow-Up |
| Initial Date Received by Manufacturer | 05/08/2026 |
| Supplement Date Received by Manufacturer | 06/02/2026
|
| Initial Report FDA Received Date | 06/02/2026 |
| Supplement Report FDA Received Date | 06/26/2026
|
| Was Device Evaluated by Manufacturer? (Y/N) |
Yes
|
| Date Device Manufactured | 02/18/2026 |
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 | CLAREON MONARCH IV IOL DELIVERY SYSTEM; CLAREON VIVITY TORIC EXTENDED VISION UV ABSORB IOL; DUOVISC VISCOELASTIC SYSTEM; MONARCH II LOADING FORCEPS |
| Patient Age | 51 YR |
| Patient Sex | Female |