ATLAS CTS 990 NA

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 05,06 report with the FDA on 2002-05-08 for ATLAS CTS 990 NA manufactured by Carl Zeiss Ophthalmic Systems.

Event Text Entries

[247669] In 2002, an associate general counsel (1) representing the user facility, reported to the manufacturer's technical support, stating the patient's printout from the time of their exam did not match the patient's file on the cts 990, and caused their surgery to be wrong, subsequently, additional information was given to the manufacturer: * that this patient had eye correction surgery in 1999. * that approximately 2 years following the surgery, the patient complained to the user facility about their dissatisfaction from the surgery and patient alleged an eye was "bad" because the exam results provided were not the patient's. * that patient had a corneal transplant about 3 months ago, but there was no additional information to confirm if the transplant was due to the surgery. * the user facility had taken 2 topographies before the surgery and one after. * that the results were printed out in color and placed into the patient's file. Some time later, the patient asked for a copy of their file to give to another doctor for a second opinion on their surgery. * that the user facility gave black and white copies of the patient's file to them. Patient came back later as the person wanting the copies they couldn't read the black and white ones and wanted the color printouts instead. * that the user facility was told that the color copies allegedly did not match the black and white copies. * that it allegedly appeared from the black and white copies (from patient hard copy file) that the patient may not have needed the surgery and that the color copies (from the instrument) belonged to someone else, as they did not match. * that the user facility pulled all patients files from the date that the patient's exam was done and found none of the topographies matched the hard copies in their files. Company have been unable to confirm or verify that there has been an actual injury.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number2918630-2002-00001
MDR Report Key397209
Report Source05,06
Date Received2002-05-08
Date of Report2002-05-08
Date of Event1999-12-09
Date Mfgr Received2002-04-09
Device Manufacturer Date1997-03-01
Date Added to Maude2002-06-04
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag0
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location0
Manufacturer ContactBILLY NAUYEN
Manufacturer Street5160 HACIENDA DRIVE
Manufacturer CityDUBLIN CA 94568
Manufacturer CountryUS
Manufacturer Postal94568
Manufacturer Phone9255574180
Manufacturer G1*
Manufacturer Street*
Manufacturer City*
Manufacturer Country*
Single Use3
Remedial ActionNO
Previous Use Code3
Removal Correction NumberNA
Event Type3
Type of Report3

Device Details

Brand NameATLAS CTS 990
Generic NameCORNEAL MAPPER
Product CodeHJB
Date Received2002-05-08
Model Number990
Catalog NumberNA
Lot NumberNA
ID NumberNA
OperatorHEALTH PROFESSIONAL
Device AvailabilityY
Device Eval'ed by MfgrY
Implant FlagN
Date RemovedA
Device Sequence No1
Device Event Key386262
ManufacturerCARL ZEISS OPHTHALMIC SYSTEMS
Manufacturer Address5160 HACIENDA DRIVE DUBLIN CA 94568 US
Baseline Brand NameMASTER VUE CORNEAL TOPOGRAPHY SYSTEMS
Baseline Generic NameCORNEAL MAPPER
Baseline Model No990
Baseline Catalog NoNA
Baseline IDNA
Baseline Device FamilyATLAS CORNEAL TOPOGRAPHY
Baseline Shelf Life [Months]NA
Baseline PMA FlagN
Baseline 510K PMNY
Premarket NotificationK913022
Baseline PreamendmentN
Baseline TransitionalN
510k ExemptN


Patients

Patient NumberTreatmentOutcomeDate
10 2002-05-08

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