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

Model Number	ZXT300
Medical Device Problem Code	Adverse Event Without Identified Device or Use Problem (2993)
Health Effect - Clinical Codes	Visual Disturbances (2140); Halo (2227); No Code Available (3191)
Date of Event	03/20/2019
Type of Reportable Event	Serious Injury
Additional Manufacturer Narrative
If explanted, give date: not applicable, the lens remains implanted.Email address unknown, information not provided.(b)(4).All pertinent information available to johnson & johnson surgical vision, inc.Has been submitted.
Event or Problem Description
It was reported at the 1-month study visit that the patient implanted with a model zxt300 intraocular lens (iol) in the left eye complained of starbursts, halos and glare which made driving difficult.At the 6-month visit the patient reported still having starburst and difficulty driving.The symptoms interfere with daily activities.Best corrected distance visual acuity (bcdva) is 20/20.No intervention is planned.
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-(b)(4) and capa-010215.
Additional Manufacturer Narrative
Additional information: additional information was received stating that at the 1-year clinical study visit, the subject reported being slightly bothered by halos- night driving; slightly bothered by starbursts- night driving.Monocular bcdva: 20/25 ou.Correction: upon review of the complaint folder, it was observed that the investigation results had not been reported.Device evaluation: the product was not returned to the manufacturing site as the product remains implanted.Therefore, product testing could not be performed and the reported complaint could not be verified.Manufacturing records review: the manufacturing records for the product was reviewed.The product was manufactured and released according to specification.A search on complaints revealed that no similar complaints have been received for this production order number.Conclusion: 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 & johnson surgical vision, inc.Has been submitted.H3 other text : placeholder.

• Brand Name: TECNIS SYMFONY TORIC
• Common Device Name: MULTIFOCAL IOLS
• Manufacturer (Section D): JOHNSON & JOHNSON SURGICAL VISION, INC.; 1700 e st andrew place; santa ana CA 92705
• MDR Report Key: 8779251
• Report Number: 9614546-2019-00604
• Device Sequence Number: 2102830
• Product Code: POE
• UDI-Device Identifier: 05050474606357
• UDI-Public: (01)05050474606357(17)210706
• Combination Product (Y/N): Y
• Initial Reporter State: WA
• Initial Reporter Country: US
• PMA/510(K) Number: P980040
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Device Implanted Year: 2019
• Reporter Type: Manufacturer
• Report Source: company representative,health
• Initial Reporter Occupation: Physician
• Type of Report: Initial,Followup,Followup
• Report Date (Section B): 11/11/2020
• 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: 07/06/2021
• Device Model Number: ZXT300
• Device Catalogue Number: ZXT300U185
• Was Device Available for Evaluation?: No
• Was the Report Sent to FDA?: No
• Date Report to Manufacturer: 01/10/2005
• Initial Date Received by Manufacturer: 06/13/2019
• Supplement Date Received by Manufacturer: 05/21/2020; 10/25/2020
• Initial Report FDA Received Date: 07/11/2019
• Supplement Report FDA Received Date: 06/15/2020; 11/12/2020
• 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: Other
• Patient Age: 72 YR
• Date Report Sent to FDA: 01/01/2005