MAUDE Adverse Event Report: JOHNSON AND JOHNSON SURGICAL VISION, INC. TECNIS SYMFONY TORIC; MULTIFOCAL IOLS

Model Number	ZXT225
Medical Device Problem Code	Adverse Event Without Identified Device or Use Problem (2993)
Health Effect - Clinical Codes	Halo (2227); No Code Available (3191)
Date of Event	12/13/2017
Type of Reportable Event	Serious Injury
Additional Manufacturer Narrative
(b)(4).All pertinent information available to johnson and johnson surgical vision, inc.Has been submitted.
Event or Problem Description
It was reported that the zxt225 +16.0 diopter intraocular lens (iol) was implanted in the patient's left eye (os) on (b)(6) 2017.The patient visited the doctor on (b)(6) 2017, and complained of pseudopakia ou (both eyes).The patient was frustrated that he could not read, which was affecting his work.He bought +1.25 otc (over-the-counter) glasses with no help.Intermediate vision has improved.Distance vision os stable; fuzzy od (right eye).Also noted was halos.Uncorrected visual acuity od: 20/100-2 distance; ph (pinhole) 20/80-2; j5 near.The lens was explanted on (b)(6) 2018, due to lack of near vision.The incision was enlarged to remove the lens but no vitrectomy was performed and no patient injury was reported.Another manufacturer's lens was implanted as a replacement.The patient was reported to be fine when discharged.No further information was provided.This report is to record the lens in the right eye.A separate mdr will be filed for the lens in the left eye.
Additional Manufacturer Narrative
Device available for evaluation? yes.Returned to manufacturer on: 08/22/2018.Device returned to manufacturer? yes.Device evaluation: the intraocular lens (iol) was returned at the manufacturing site for evaluation.Visual inspection showed that the lens was cut in pieces, most probably to make the explant possible.Considering the condition of the lens additional analysis was not possible.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.Historical data analysis: a search revealed that no similar complaints for this order number have been received.Labeling review: the directions for use (dfu) were reviewed.The directions for use (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 johnson and johnson surgical vision, inc.Has been submitted.
Additional Manufacturer Narrative
This correction mdr is being submitted to address inaccurate information in section f on the xml version of the previous submission caused by a software glitch in the transmission process.The internal non-conformance numbers for this software issue are nr-0148919 and capa-010215.

• Brand Name: TECNIS SYMFONY TORIC
• Common Device Name: MULTIFOCAL IOLS
• Manufacturer (Section D): JOHNSON AND JOHNSON SURGICAL VISION, INC.; santa ana CA
• MDR Report Key: 7737448
• Report Number: 9614546-2018-00737
• Device Sequence Number: 16398567
• Product Code: POE
• UDI-Device Identifier: 05050474605718
• UDI-Public: (01)05050474605718(17)211014
• Combination Product (Y/N): Y
• Initial Reporter State: MD
• 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: 2018
• Reporter Type: Manufacturer
• Report Source: company representative,health
• Initial Reporter Occupation: Physician
• Type of Report: Initial,Followup,Followup
• Report Date (Section B): 11/02/2020
• Report Date (Section F): 01/01/2005

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: Health Professional
• Device Expiration Date: 10/14/2021
• Device Model Number: ZXT225
• Device Catalogue Number: ZXT225U160
• Was Device Available for Evaluation?: Device Returned to Manufacturer
• Date Returned to Manufacturer: 08/22/2018
• Was the Report Sent to FDA?: No
• Date Report to Manufacturer: 01/10/2005
• Initial Date Received by Manufacturer: 07/06/2018
• Supplement Date Received by Manufacturer: 09/06/2018; 10/25/2020
• Initial Report FDA Received Date: 07/31/2018
• Supplement Report FDA Received Date: 09/18/2018; 11/02/2020
• 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
• Date Report Sent to FDA: 01/01/2005