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

Model Number	ZXT300
Medical Device Problem Code	Unintended Movement (3026)
Health Effect - Clinical Codes	Capsular Bag Tear (2639); Vitrectomy (2643); No Code Available (3191)
Date of Event	11/27/2017
Type of Reportable Event	Serious Injury
Additional Manufacturer Narrative
Date of event: unknown, not provided, but the best estimate date is between (b)(6) 2017.(b)(4).All pertinent information available to abbott medical optics has been submitted.
Event or Problem Description
It was reported that a zxt300 17.0 diopter intraocular lens (iol) was implanted in the left eye (os) on (b)(6) 2017 using a capsular tension ring (ctr).Once the lens was in the capsular bag, the doctor started moving the lens around and the iol ended up popping out of the capsular bag and caused it to tear.The doctor tried performing a reverse optic capture, but he iol didn't stay well-centered and he couldn't suture it into good position either.Post-operatively, because the lens didn't stay centered, the doctor attempted a lens repositioning procedure on (b)(6) 2017, but was unable to keep the lens centered.Also, a pars plana vitrectomy was performed after the lens repositioning.The lens was later explanted on (b)(6) 2017 and the replacement lens was a non-amo lens.There was no patient injury post-operatively.No additional information was provided.
Additional Manufacturer Narrative
Device available for evaluation? yes.Returned to manufacturer on: 01/12/2018.Device returned to manufacturer? yes.Device evaluation: the sample was returned to the manufacturer.Visual inspection at 12x microscope magnification was performed.It can be seen that the lens was contaminated and it was cut in the middle probably to make explant possible.The complaint cannot be confirmed.Manufacturing record review: manufacturing records were reviewed and the lens was manufactured according to specification.A search on complaints revealed no similar complaints were received for this production order number to date.Labeling review: the directions for use (dfu) was reviewed.The dfu adequately provides instructions and precautions for the proper use and handling of the intraocular lenses.Conclusion: based on the investigation results there is no indication of a product quality deficiency.All pertinent information available to johnson and johnson surgical vision, inc.Has been submitted.

• Brand Name: TECNIS SYMFONY TORIC
• Common Device Name: MULTIFOCAL IOLS
• Manufacturer (Section D): ABBOTT MEDICAL OPTICS; santa ana CA 92705
• MDR Report Key: 7145939
• Report Number: 9614546-2017-01257
• Device Sequence Number: 1132621
• Product Code: POE
• UDI-Device Identifier: 05050474606326
• UDI-Public: (01)05050474606326(17)210829
• Combination Product (Y/N): N
• Initial Reporter State: CA
• Initial Reporter Country: US
• PMA/510(K) Number: P980040
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Device Implanted Year: 2017
• Device Explanted Year: 2017
• Reporter Type: Manufacturer
• Report Source: company representative,health
• Initial Reporter Occupation: Physician
• Type of Report: Initial,Followup
• Report Date (Section B): 04/11/2018

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?: Yes
• Operator of Device: Physician
• Device Expiration Date: 08/29/2021
• Device Model Number: ZXT300
• Device Catalogue Number: ZXT300U170
• Was Device Available for Evaluation?: Device Returned to Manufacturer
• Date Returned to Manufacturer: 01/12/2018
• Initial Date Received by Manufacturer: 11/27/2017
• Supplement Date Received by Manufacturer: 03/13/2018
• Initial Report FDA Received Date: 12/26/2017
• Supplement Report FDA Received Date: 04/12/2018
• Is This a Single-Use Device that was Reprocessed and Reused on a Patient? (Y/N): No
• Patient Sequence Number: 1
• Concomitant Medical Products and Therapy/Usage Dates: CAPSULAR TENSION RING, SERIAL (B)(4)
• Outcome Attributed to Adverse Event: Required Intervention
• Patient Age: 59 YR