ALLERGAN CUP (GORETEX)

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 04 report with the FDA on 2005-10-27 for ALLERGAN CUP (GORETEX) manufactured by Allergan, Inc..

Event Text Entries

[539735] The manufacturer of a contact lens care cup for use with 3 percent hydrogen peroxide systems received a report from another country that a lens cup cracked during neutralization. No patent injury occurred. The lens cup was used with an incompatible product - it was not used according to labeling. The lens cup was forwarded to the manufacturer for evaluation; results of performance testing were within specification. Event was caused by user error.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number2020664-2005-00028
MDR Report Key757915
Report Source04
Date Received2005-10-27
Date of Report2005-10-27
Date of Event2005-09-09
Date Mfgr Received2005-09-09
Date Added to Maude2006-09-08
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 ContactAVERY FUNK
Manufacturer Street1700 E ST. ANDREW PLACE
Manufacturer CitySANTA ANA CA 92710
Manufacturer CountryUS
Manufacturer Postal92710
Manufacturer Phone7142478601
Manufacturer G1ALLERGAN
Manufacturer Street8301 MARS DRIVE
Manufacturer CityWACO TX 76712
Manufacturer CountryUS
Manufacturer Postal Code76712
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameALLERGAN CUP (GORETEX)
Generic NameCONTACT LENS CARE PRODUCT
Product CodeHRD
Date Received2005-10-27
Model NumberNA
Catalog NumberNA
Lot NumberNA
ID NumberNA
OperatorLAY USER/PATIENT
Device AvailabilityY
Device Eval'ed by MfgrY
Implant FlagN
Date RemovedA
Device Sequence No1
Device Event Key745815
ManufacturerALLERGAN, INC.
Manufacturer Address8301 MARS DRIVE WACO TX 76712 US


Patients

Patient NumberTreatmentOutcomeDate
10 2005-10-27

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