MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a health professional,user faci report with the FDA on 2020-03-20 for CRYSTALSERT INSERTER CI-28 manufactured by Bausch + Lomb.
[184827081]
The inserter was not returned for evaluation. The lot history, trend analysis, risk analysis and directions for use review are considered acceptable, with the product performing within anticipated rates. A definitive root cause cannot be determined. The most probable root cause is operational context. User related factors (such as loading or handling techniques) and/or procedural factors (such as lens and inserter interaction) might have contributed to the event. No corrective action is necessary at this time.
Patient Sequence No: 1, Text Type: N, H10
[184827082]
It was reported that during insertion of an intraocular lens (iol) into the right eye it was noticed that the haptic was torn. The iol was removed with lens forceps. There was no incision enlargement and no sutures were required. The patient had a vitrectomy and had a different lens implanted. Though requested, no additional information has been received. The reason for vitrectomy was not provided.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 0001313525-2020-00058 |
| MDR Report Key | 9860793 |
| Report Source | HEALTH PROFESSIONAL,USER FACI |
| Date Received | 2020-03-20 |
| Date of Report | 2020-02-13 |
| Date of Event | 2020-02-12 |
| Report Date | 2005-01-01 |
| Date Reported to FDA | 2005-01-01 |
| Date Reported to Mfgr | 2005-01-10 |
| Date Mfgr Received | 2020-02-19 |
| Date Added to Maude | 2020-03-20 |
| Event Key | 0 |
| Report Source Code | Manufacturer report |
| Manufacturer Link | Y |
| Number of Patients in Event | 0 |
| Adverse Event Flag | 3 |
| Product Problem Flag | 3 |
| Reprocessed and Reused Flag | 3 |
| Reporter Occupation | OTHER HEALTH CARE PROFESSIONAL |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 3 |
| Event Location | 3 |
| Manufacturer Contact | STEPHANIE ANASTASIOU |
| Manufacturer Street | 21 NORTH PARK PLACE BLVD. |
| Manufacturer City | CLEARWATER FL 33759 |
| Manufacturer Country | US |
| Manufacturer Postal | 33759 |
| Manufacturer Phone | 7277246659 |
| Single Use | 0 |
| Previous Use Code | 0 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | CRYSTALSERT INSERTER |
| Generic Name | FOLDERS AND INJECTORS, INTRAOCULAR LENS (IOL) |
| Product Code | MSS |
| Date Received | 2020-03-20 |
| Model Number | CI-28 |
| Lot Number | UNKNOWN |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | N |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | BAUSCH + LOMB |
| Manufacturer Address | 1400 NORTH GOODMAN STREET ROCHESTER NY 14609 US 14609 |
| Product Code | --- |
| Date Received | 2020-03-20 |
| Device Sequence No | 101 |
| Device Event Key | 0 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 1. Required No Informationntervention | 2020-03-20 |