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The product was not returned for analysis.A manufacturing batch record review and a non-conformance review of the reported batch number was conducted.No deviations were identified and all corresponding production release specifications defined in the medical device file were met.The reporter states the use of "hiluron -1.4%" as a viscoelastic, which is not qualified to be used with the associated product.The reported complaint was not observed as no sample was returned for analysis; however, based on the information provided by the customer, the most likely root cause is failure to follow instructions for use (ifu), as the customer states the use of a non-qualified viscoelastic.The use of an unqualified ophthalmic visco surgical device (ovd) may cause damage to the lens and potential complications during the implantation process.Other potential contributing factors to the reported event include: if the lens has become misaligned in the lens bay during the manufacturing process.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 allowing the plunger to override the lens.If the operating room temperature is too high (> 23 degrees celsius/73 degrees fahrenheit) lens folding consistency is negatively affected, the lens is more adherent and this may inhibit lens advancement.If ovd has not been allowed to come to operating room temperature over a 20 minute timeframe prior to use.Colder temperatures can increase the ovd viscosity, creating greater resistance during intraocular lens (iol) delivery, causing potential unsuccessful delivery outcomes.Any of the above listed causes alone, or in combination, may create the reported event.Based on the results from the manufacturing batch record, the products met release criteria.The manufacturer internal reference number is: (b)(4).
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