CYSTOTOME * E-141-2S

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2008-03-20 for CYSTOTOME * E-141-2S manufactured by Bausch & Lomb.

Event Text Entries

[19463839] Black particulate flaking from bausch & lomb ophthalmic instruments: irrigation cannula, straight cannula, polisher, & cystotome. Particulate removed from surgical site via microscopic visualization. Response from bausch & lomb indicated that some lots of instrument hubs were manufactured with a thinner than usual brass coating on the nickel hub. Instrument hubs deteriorated with proper sterilization technique. Dates of use #1: 3 1/2 years; #2: 3 1/2 years. Diagnosis or reason for use #1: instrumentation, #2: instrumentation. Event abated after use stopped: #1: yes; #2: yes.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report NumberMW5005968
MDR Report Key1017532
Date Received2008-03-20
Date of Report2008-03-20
Date of Event2007-09-11
Date Added to Maude2008-03-31
Event Key0
Report Source CodeVoluntary report
Manufacturer LinkN
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location0
Single Use0
Previous Use Code0
Event Type3
Type of Report3

Device Sequence Number: 1

Brand NameCYSTOTOME
Generic NameCYSTOTOME
Product CodeHNY
Date Received2008-03-20
Returned To Mfg2008-02-15
Model Number*
Catalog NumberE-141-2S
Lot Number*
ID Number*
OperatorHEALTH PROFESSIONAL
Device AvailabilityR
Implant FlagN
Date RemovedB
Device Sequence No1
Device Event Key986518
ManufacturerBAUSCH & LOMB
Manufacturer Address3365 TREE COURT INDUSTR. BLVD ST. LOUIS MO 63122 US

Device Sequence Number: 2

Brand NamePOLISHER
Generic NamePOLISHER
Product CodeHMF
Date Received2008-03-20
Returned To Mfg2008-02-15
Catalog NumberE508
OperatorHEALTH PROFESSIONAL
Device AvailabilityR
Implant FlagN
Date RemovedB
Device Sequence No2
Device Event Key986519
ManufacturerBAUSCH & LOMB
Manufacturer Address3365 TREE COURT INDUSTR. BLVD LOUIS MO 63122 US

Device Sequence Number: 3

Brand NameIRRIGATION CANNULA
Generic NameIRRIGATION CANNULA
Product CodeHMX
Date Received2008-03-20
Returned To Mfg2008-02-15
Catalog NumberE4922
OperatorHEALTH PROFESSIONAL
Device AvailabilityR
Implant FlagN
Date RemovedB
Device Sequence No3
Device Event Key986520
ManufacturerBAUSCH & LOMB
Manufacturer Address3365 TREE COURT INDUSTR. BLVD LOUIS MO 63122 US

Device Sequence Number: 4

Brand NameSTRAIGHT CANNULA
Generic NameSTRAIGHT CANNULA
Product CodeHMX
Date Received2008-03-20
Returned To Mfg2008-02-15
Catalog NumberE499-27
OperatorHEALTH PROFESSIONAL
Device AvailabilityR
Implant FlagN
Date RemovedB
Device Sequence No4
Device Event Key986521
ManufacturerBAUSCH & LOMB
Manufacturer Address3365 TREE COURT INDUST. BLVD LOUIS MO 63122 US


Patients

Patient NumberTreatmentOutcomeDate
101. Deathisabilit 2008-03-20

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