MAUDE MDR 6436121

MDR report key
6436121
Report number
0001313525-2017-02346
Event key
0
Event type
3
Date of event
2014-04-04
Date received
2017-03-27
Adverse event
3
Product problem
3
Patients in event
0
Reporter occupation
0
Health professional
3
Initial report to FDA
3
Event location
3

Manufacturer Contact#

Contact
MS. SHARON SPENCER
Address
50 TECHNOLOGY DRIVE WEST IRVINE CA 92618 US
Phone
949-949-9493
Report source
M
Manufacturer link flag
Y

Devices#

Seq, Brand, Generic table
SeqBrandGenericManufacturerProduct codeModelCatalogLotPMA510(k)ImplantEvaluatedAvailability
1BIOTRUE MULTI-PURPOSE SOLUTIONACCESSORIES, SOLUTION, CLEANERS FOR LENSESBAUSCH & LOMB INCORPORATEDLYLR N

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
12017-03-2701. O

Event Narratives#

N

Patient 1

THE COMPLAINT SAMPLE WAS NOT RETURNED FOR EVALUATION AND THE LOT NUMBER IS UNKNOWN. ADDITIONAL EVENT DETAILS ARE NOT AVAILABLE GIVEN THAT THE CONSUMER DECLINED TO DISCLOSE HIS CONTACT INFORMATION. IT IS POSSIBLE THAT REPEATED UNSUCCESSFUL ATTEMPTS TO INSERT THE LENS MAY HAVE RESULTED IN TRAUMA TO THE CONSUMER?S OCULAR SURFACE. ADDITION OF A SOLUTION TO A TRAUMATIZED EYE CAN RESULT IN A BURNING SENSATION. NEVERTHELESS, BASED ON AVAILABLE INFORMATION, NO CAUSAL FACTORS CAN BE DETERMINED AND NO CONCLUSIONS CAN BE DRAWN. CONSUMER LISTS THE FOLLOWING CONCOMITANT PRODUCTS ON THE MEDWATCH: "METHADONE 10X3, METOPROLOL 50X2, OMEPRAZOLE 20 MGS 1HS, SIMVASTATIN 40 1HS, XANAX 1MGX2, VALIUM 1HS, SAW PALMETTO 6 CAPSULES, MULTIVITMAN, B 12 500MCG".

D

Patient 1

MEDWATCH REPORT RECEIVED FROM FDA, MW5068141. CONSUMER REPORTED FIRST STARTING USE OF THE PRODUCT IN 2013. THE EVENT DATE REPORTED BY THE CONSUMER (B)(6) 2014 AND THE REPORT TO MEDWATCH WAS 23-FEB-2017. CONSUMER REPORTED THAT HE HAD MANY UNSUCCESSFUL ATTEMPTS AT INSERTING HIS LENSES AND WAS INSTRUCTED BY HIS SPOUSE TO USE A DROP OF THE PRODUCT TO FACILITATE INSERTION. WITH THE DROP, THE LENS WAS APPLIED TO THE LEFT EYE AND THE CONSUMER REPORTED THAT HE EXPERIENCED INTENSE BURNING. THE CONSUMER REPORTED THAT HE SAW A DOCTOR FOR EVALUATION AND RECALLED THAT THE DOCTOR STATED THAT, "THE SKIN WAS BURNT OFF MY EYES." THE CONSUMER ALSO RECALLED THAT THE DOCTOR GAVE HIM DROPS (UNSPECIFIED) THAT HE HAD IN HIS OFFICE AND GAVE HIM AN RX FOR AN ANTIBIOTIC, "TO EASE THE INFECTION." CONSUMER REMARKED, ?TO THIS DAY, THE SKIN IS STILL OFF MY EYES AND NOTHING CAN BE DONE.?