IFS J20007K

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a company representative,foreig report with the FDA on 2020-03-26 for IFS J20007K manufactured by Johnson & Johnson Surgical Vision, Inc..

Event Text Entries

[185087398] Age/date of birth: unknown/ not provided. (b)(6). (b)(4). Device evaluation the femtosecond laser machine was examined and tested at the customer location by an jjsv field service specialist (fss). The fss checked gel at surgery settings. 80 percent melt. Easy lift. The fss performed a field service checklist. The system was verified for all modes of operations. The system met jjsv specifications. A review of records related to the device including labeling, complaint trending, and risk documentation will be performed. Upon completion of this review, if there is any further relevant information obtained, a supplemental medwatch will be filed. All pertinent information available to johnson & johnson surgical vision, inc. Has been submitted.
Patient Sequence No: 1, Text Type: N, H10


[185087399] It was reported that a laser vision correction patient experienced a free flap on the patient? S right operative eye on treatment date (b)(6) 2020. A description of the event is the surgeon encountered a free flap on the patient right eye while lifting flap. He replaced the flap and aligned into position after completing excimer laser. Routine post-op drops and bcl prescribed post-op. At a one-day post op exam, the surgeon noted epithelial abrasion on the right eye (re), however had a good flap edge. It was also noted the left eye (le) had epithelial abrasion outside the flap edge with good flap edges. Additionally, it was reported the surgeon is new to using the laser equipment. Ucva at one day post op. Re 6/7. 5 le 6/7. 5.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number3006695864-2020-00210
MDR Report Key9882481
Report SourceCOMPANY REPRESENTATIVE,FOREIG
Date Received2020-03-26
Date of Report2020-03-26
Date of Event2020-02-29
Report Date2005-01-01
Date Reported to FDA2005-01-01
Date Reported to Mfgr2005-01-10
Date Mfgr Received2020-03-02
Date Added to Maude2020-03-26
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 Location3
Manufacturer ContactSOMYATA NAGPAL
Manufacturer Street1700 EAST ST. ANDREW PLACE
Manufacturer CitySANTA ANA CA 92705
Manufacturer CountryUS
Manufacturer Postal92705
Manufacturer Phone7142478200
Manufacturer G1JOHNSON & JOHNSON SURGICAL VISION, INC.
Manufacturer Street510 COTTONWOOD DRIVE
Manufacturer CityMILPITAS CA 95035
Manufacturer CountryUS
Manufacturer Postal Code95035
Single Use0
Previous Use Code0
Event Type3
Type of Report3

Device Sequence Number: 1

Brand NameIFS
Generic NameFEMTOSECOND LASER
Product CodeHNO
Date Received2020-03-26
Model NumberJ20007K
OperatorHEALTH PROFESSIONAL
Device AvailabilityY
Device Sequence No1
Device Event Key0
ManufacturerJOHNSON & JOHNSON SURGICAL VISION, INC.
Manufacturer Address1700 E ST ANDREW PLACE SANTA ANA CA 92705 US 92705

Device Sequence Number: 101

Product Code---
Date Received2020-03-26
Device Sequence No101
Device Event Key0


Patients

Patient NumberTreatmentOutcomeDate
101. Required No Informationntervention 2020-03-26

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