EAGLE PLUG1 3001

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 05 report with the FDA on 2014-07-15 for EAGLE PLUG1 3001 manufactured by Eaglevision, Inc..

Event Text Entries

[16082865] Physician reported that he inserted 2 punctum plugs into a patient after properly gauging the punctas. / at a follow-up appointment he found a pyogenic granuloma in one of the punctas. The plug was removed and the patient treated with dexamethasone for 10 days. The granuloma has almost completely resolved.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number1034718-2014-00005
MDR Report Key4088123
Report Source05
Date Received2014-07-15
Date of Report2014-06-16
Date of Event2014-04-30
Date Mfgr Received2014-06-16
Device Manufacturer Date2011-09-01
Date Added to Maude2014-09-16
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional3
Initial Report to FDA3
Report to FDA0
Event Location0
Manufacturer ContactMR BILL GRAHAM
Manufacturer Street8500 WOLF LAKE DR. SUITE 110
Manufacturer CityMEMPHIS TN 38133
Manufacturer CountryUS
Manufacturer Postal38133
Manufacturer Phone9013807000
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameEAGLE PLUG1
Generic NamePUNCTUM PLUG
Product CodeLZU
Date Received2014-07-15
Catalog Number3001
Lot Number76987
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device AgeDA
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerEAGLEVISION, INC.
Manufacturer AddressMEMPHIS TN US


Patients

Patient NumberTreatmentOutcomeDate
101. Required No Informationntervention 2014-07-15

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