| 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
|
|
+1(800)757-9780
|
|
| MDR Report Key | 50884529 |
| Report Number | 1119421-2026-01933 |
| Device Sequence Number | 13218288 |
| Product Code |
KYB
|
| UDI-Device Identifier | 00380652394796 |
| Combination Product (Y/N) | N |
| Initial Reporter Country | TH |
| PMA/510(K) Number | P930014 |
| Number of Events Summarized | 1 |
| Summary Report (Y/N) | N |
| Reporter Type |
Manufacturer
|
| Report Source |
Foreign,Health Professional,Company Representative |
| Initial Reporter Occupation |
Other Health Care Professional
|
| Type of Report
| Initial |
| Report Date (Section B) |
09/24/2026 |
| 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 | 16118040 |
| Was Device Available for Evaluation? |
No
|
| Is the Reporter a Health Professional? |
Yes
|
| Initial Date Received by Manufacturer | 09/03/2026 |
| Initial Report FDA Received Date | 09/24/2026 |
| Date Device Manufactured | 09/23/2025 |
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 |
Concomitant Medical Products and Therapy/Usage Dates | AcrySof IQ Singlepiece, Delivery System |
| Patient Sex | Unknown |
|
|