VISCO360 VISCOSURGICAL SYSTEM 05172

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a company representative,foreig report with the FDA on 2017-03-28 for VISCO360 VISCOSURGICAL SYSTEM 05172 manufactured by Sight Sciences, Inc..

Event Text Entries

[71102643] The device instructions for use were reviewed. They were found to be adequate and with no deficiencies. A review of the product lot history records for this lot of devices did not reveal any production nonconformance, anomaly or any other background that would help explain the circumstances for this complaint. The device was discarded by the facility and is not available for evaluation. All pertinent information available to sight sciences, inc. Has been submitted. The company is submitting this mdr to ensure full compliance with 21 cfr 803. (b)(4).
Patient Sequence No: 1, Text Type: N, H10


[71102644] The visco360 device was used to viscodilate schlemm's canal in a patient with refractory glaucoma. The surgeon reported advancing the microcatheter 180 degrees in the canal and resistance was encountered when attempting to retract the microcatheter and viscodilate. Shortly afterwards, the microcatheter severed. Using retinal forceps, the surgeon successfully removed the catheter from the eye by performing a 180 degree goniotomy with the microcatheter. He elected to remove the device with a goniotomy since he had already been considering performing goniotomy during this procedure to treat the patient's refractory glaucoma. Using a new visco360 device, the surgeon then successfully performed viscodilation of the remaining 180 degrees of schlemm's canal. The event did not result in an adverse impact to the patient. The patient's day 1 iop was reported to be 18 mmhg.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number3010363671-2017-00009
MDR Report Key6439251
Report SourceCOMPANY REPRESENTATIVE,FOREIG
Date Received2017-03-28
Date of Report2017-02-23
Date of Event2017-02-21
Date Mfgr Received2017-03-02
Device Manufacturer Date2016-12-07
Date Added to Maude2017-03-28
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 FDA3
Event Location3
Manufacturer ContactANNE-MARIE RIPLEY
Manufacturer Street3000 SAND HILL ROAD, 3-105
Manufacturer CityMENLO PARK CA 94025
Manufacturer CountryUS
Manufacturer Postal94025
Manufacturer Phone6616458546
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameVISCO360 VISCOSURGICAL SYSTEM
Generic NameVISCOELASTIC INJECTOR
Product CodeMRH
Date Received2017-03-28
Model Number05172
Catalog Number05172
Lot Number1005114
Device Expiration Date2017-12-31
OperatorPHYSICIAN
Device AvailabilityN
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerSIGHT SCIENCES, INC.
Manufacturer Address3000 SAND HILL ROAD, 3-105 MENLO PARK CA 94025 US 94025


Patients

Patient NumberTreatmentOutcomeDate
10 2017-03-28

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