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 distributor,foreign,health pr report with the FDA on 2017-04-20 for VISCO360 VISCOSURGICAL SYSTEM 05172 manufactured by Sight Sciences, Inc..

Event Text Entries

[73460066] 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). Submitted to fda on: april 20, 2017.
Patient Sequence No: 1, Text Type: N, H10


[73460067] The device was being used to perform viscodilation of the left eye. The microcatheter was advanced 180 degrees. Upon retraction, the surgeon felt resistance. He observed the microcatheter was severed and remained in schlemm's canal. Using retinal forceps, the surgeon successfully removed the catheter from the eye by performing 90 degree goniotomy with the microcatheter and then removing the rest of the microcatheter from the canal. The surgeon used a new device to compete the case. There were no intraoperative or post-operative complications.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number3010363671-2017-00017
MDR Report Key6508202
Report SourceDISTRIBUTOR,FOREIGN,HEALTH PR
Date Received2017-04-20
Date of Report2017-03-28
Date of Event2017-03-23
Date Mfgr Received2017-03-28
Device Manufacturer Date2016-12-12
Date Added to Maude2017-04-20
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 RD., 3-105
Manufacturer CityMENLO PARK CA 94025
Manufacturer CountryUS
Manufacturer Postal94025
Manufacturer Phone6616458546
Manufacturer G1SIGHT SCIENCES, INC.
Manufacturer Street3000 SAND HILL RD., 3-105
Manufacturer CityMENLO PARK CA 94025
Manufacturer CountryUS
Manufacturer Postal Code94025
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameVISCO360 VISCOSURGICAL SYSTEM
Generic NameVISCOELASTIC INJECTOR
Product CodeMRH
Date Received2017-04-20
Model Number05172
Catalog Number05172
Lot Number1005123
Device Expiration Date2017-12-31
OperatorPHYSICIAN
Device AvailabilityY
Device Eval'ed by MfgrY
Device Sequence No1
Device Event Key0
ManufacturerSIGHT SCIENCES, INC.
Manufacturer Address3000 SAND HILL RD., 3-105 MENLO PARK CA 94025 US 94025


Patients

Patient NumberTreatmentOutcomeDate
10 2017-04-20

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