ARGUS II RETINAL PROSTHESIS 011013-003-K 011013

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a foreign,health professional,s report with the FDA on 2017-04-21 for ARGUS II RETINAL PROSTHESIS 011013-003-K 011013 manufactured by Second Sight Medical Products, Inc..

Event Text Entries

[73385006]
Patient Sequence No: 1, Text Type: N, H10


[73385007] Patient (b)(6) was implanted with an argus ii device on (b)(6) 2014, and was later explanted and re-implanted with another argus ii device during the same procedure on (b)(6) 2015. On (b)(6) 2017, the patient was diagnosed with conjunctival erosion and a retinal detachment. On (b)(6) 2017, revision surgery was performed during which the implant was covered with a bovine pericardium patch graft, and the conjunctiva was closed. The surgeon reported that the retinal detachment was stable and did not require surgical intervention. There was no defect or malfunction of the device associated with this event.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number3004081696-2017-00007
MDR Report Key6511914
Report SourceFOREIGN,HEALTH PROFESSIONAL,S
Date Received2017-04-21
Date of Report2017-03-24
Date of Event2017-03-24
Date Mfgr Received2017-03-24
Device Manufacturer Date2014-12-21
Date Added to Maude2017-04-21
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 ContactMR. MARK LOAR
Manufacturer Street12744 SAN FERNANDO RD. SUITE 400
Manufacturer CitySYLMAR CA 91342
Manufacturer CountryUS
Manufacturer Postal91342
Manufacturer Phone8188335049
Manufacturer G1SECOND SIGHT MEDICAL PRODUCTS, INC.
Manufacturer Street12744 SAN FERNANDO RD. SUITE 400
Manufacturer CitySYLMAR CA 91342
Manufacturer CountryUS
Manufacturer Postal Code91342
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameARGUS II RETINAL PROSTHESIS
Generic NameRETINAL PROSTHESIS
Product CodeNBF
Date Received2017-04-21
Model Number011013-003-K
Catalog Number011013
Lot NumberN/A
Device Expiration Date2016-12-21
OperatorPHYSICIAN
Device AvailabilityN
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerSECOND SIGHT MEDICAL PRODUCTS, INC.
Manufacturer Address12744 SAN FERNANDO RD. SUITE 400 SYLMAR CA 91342 US 91342


Patients

Patient NumberTreatmentOutcomeDate
101. Hospitalization; 2. Required No Informationntervention 2017-04-21

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