MAUDE Adverse Event Report: ABBOTT MEDICAL OPTICS TECNIS SYMFONY TORIC; MULTIFOCAL IOLS

Model Number	ZCT450
Medical Device Problem Code	Adverse Event Without Identified Device or Use Problem (2993)
Health Effect - Clinical Codes	Blurred Vision (2137); No Code Available (3191)
Date of Event	02/20/2017
Type of Reportable Event	Serious Injury
Additional Manufacturer Narrative
(b)(4).All pertinent information available to the manufacturer has been submitted.
Event or Problem Description
It was reported that a model zxt375 29.5 diopter intraocular lens (iol) was explanted from a female patient's right eye due to complications of iol, blurry vision.The lens was replaced with the same model, a smaller, 29.0 diopter lens.No further information was provided.
Additional Manufacturer Narrative
Correction - account reported they initially provided an incorrect serial number and model for the reported event for the right eye.A corrected model and serial number was provided and the following fields were updated accordingly: it was reported that a model zct450 29.0 diopter intraocular lens (iol) was explanted from a female patient's right eye due to complications of the intraocular lens (iol), blurry vision.The lens was replaced with a zxt375 29.0 diopter lens.No patient injury was reported.Additionally it was reported that the patient also underwent explant of the lens implanted in her left eye.A separate mdr will be filed for the lens from the left eye.Expiration date 2/18/2021.Model zct450.Catalog number zct450u290.Serial (b)(4).Implant date (b)(6) 2016.Manufacturing date 02/08/2016.All pertinent information available to abbott medical optics has been submitted.
Additional Manufacturer Narrative
Device evaluation: the intraocular lens (iol) was not returned to the manufacturing site.Therefore, product testing could not be performed and the customer¿s reported complaint could not be verified.Manufacturing records review: the manufacturing records for the intraocular lens were reviewed.The product was manufactured and released according to specification.A search on complaints revealed no similar complaints have been received for this production order.Labeling review: the directions for use (dfu) was reviewed.The dfu adequately provides instructions and precautions along with warnings for the proper use and handling of the device.As a result of the investigation there is no indication of a product quality deficiency and the reported issue could not be verified.All pertinent information available to abbott medical optics has been submitted.

• Brand Name: TECNIS SYMFONY TORIC
• Common Device Name: MULTIFOCAL IOLS
• Manufacturer (Section D): ABBOTT MEDICAL OPTICS; santa ana CA
• MDR Report Key: 6465543
• Report Number: 9614546-2017-00279
• Device Sequence Number: 608936
• Product Code: POE
• UDI-Device Identifier: 05050474607163
• UDI-Public: (01)05050474607163(17)210729
• Combination Product (Y/N): N
• Initial Reporter State: AL
• Initial Reporter Country: US
• PMA/510(K) Number: P980040
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Device Implanted Year: 2016
• Device Explanted Year: 2017
• Reporter Type: Manufacturer
• Report Source: company representative,health
• Initial Reporter Occupation: Physician
• Type of Report: Initial,Followup,Followup
• Report Date (Section B): 08/31/2017

1 Device was Involved in the Event

1 Patient was Involved in the Event

• Is this an Adverse Event Report?: Yes
• Is this a Product Problem Report?: No
• Operator of Device: Physician
• Device Expiration Date: 02/18/2021
• Device Model Number: ZCT450
• Device Catalogue Number: ZCT450U290
• Was Device Available for Evaluation?: No
• Initial Date Received by Manufacturer: 03/10/2017
• Supplement Date Received by Manufacturer: Not provided; 08/08/2017
• Initial Report FDA Received Date: 04/06/2017
• Supplement Report FDA Received Date: 05/09/2017; 08/31/2017
• Is This a Single-Use Device that was Reprocessed and Reused on a Patient? (Y/N): No
• Patient Sequence Number: 1
• Outcome Attributed to Adverse Event: Required Intervention
• Patient Age: 34 YR