LARGE DIAMETER LACRIMAL INTUBATION SET/STENTTUBE LIS052 *

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 06 report with the FDA on 2006-04-12 for LARGE DIAMETER LACRIMAL INTUBATION SET/STENTTUBE LIS052 * manufactured by Quest Medical, Inc..

Event Text Entries

[21609599] The large stentubes break too often when being pulled through even if ointment is applied first. The product was not saved for evaluation.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number1649914-2006-00024
MDR Report Key703008
Report Source06
Date Received2006-04-12
Date of Report2006-03-30
Date Mfgr Received2006-02-28
Date Added to Maude2006-04-26
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 Location0
Manufacturer ContactKATHRYN JAYNE
Manufacturer StreetONE ALLENTOWN PARKWAY
Manufacturer CityALLEN TX 75002
Manufacturer CountryUS
Manufacturer Postal75002
Manufacturer Phone9723909800
Manufacturer G1*
Manufacturer Street*
Manufacturer City*
Manufacturer Country*
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameLARGE DIAMETER LACRIMAL INTUBATION SET/STENTTUBE
Generic NameMANUAL OPHTHALMIC SURGICAL INSTRUMENT: LACRYMAL PROBE
Product CodeHNW
Date Received2006-04-12
Model NumberLIS052
Catalog Number*
Lot NumberUNK
ID Number*
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device Eval'ed by MfgrR
Implant FlagN
Date RemovedA
Device Sequence No1
Device Event Key692136
ManufacturerQUEST MEDICAL, INC.
Manufacturer AddressONE ALLENTOWN PKWY. ALLEN TX 75002 US
Baseline Brand NameSTENTUBE
Baseline Generic NameOPHTHALMIC INTUBATION TUBE
Baseline Model NoLIS052
Baseline Catalog NoLIS052
Baseline ID*


Patients

Patient NumberTreatmentOutcomeDate
10 2006-04-12

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