ALLEGRETTO WAVE EYE-Q EXCIMER LASER 8065990739

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a health professional report with the FDA on 2020-03-30 for ALLEGRETTO WAVE EYE-Q EXCIMER LASER 8065990739 manufactured by Wavelight Gmbh.

Event Text Entries

[187084855] The device history records (dhr) for the device were reviewed. The associated device was released based on acceptance criteria. A review of the technical service onsite history showed no abnormalities that could have contributed to this event: laser was successfully verified prior to treatment date. The root cause could not be identified conclusively. No udi required due to this device was out of production prior to the september 24, 2014 udi regulation date. The manufacturer internal reference number is: (b)(4).
Patient Sequence No: 1, Text Type: N, H10


[187084856] An optometrist reported a patient presented with severe pain and blurry vision in the left eye two months post lasik. The patient stated it felt like a rock in the eye. The patient was noted to have a large corneal erosion. Additional information requested.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number3003288808-2020-00242
MDR Report Key9896903
Report SourceHEALTH PROFESSIONAL
Date Received2020-03-30
Date of Report2020-03-30
Date of Event2020-03-03
Date Mfgr Received2020-03-03
Device Manufacturer Date2008-10-23
Date Added to Maude2020-03-30
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Reporter OccupationOTHER HEALTH CARE PROFESSIONAL
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer ContactMR. JONATHAN SCHLECH
Manufacturer Street6201 SOUTH FREEWAY MAIL STOP AB2-6
Manufacturer CityFORT WORTH TX 76134
Manufacturer CountryUS
Manufacturer Postal76134
Manufacturer Phone8175514979
Manufacturer G1WAVELIGHT GMBH
Manufacturer StreetAM WOLFSMANTEL 5
Manufacturer CityERLANGEN 91058
Manufacturer CountryGM
Manufacturer Postal Code91058
Single Use3
Previous Use Code3
Removal Correction NumberNA
Event Type3
Type of Report3

Device Details

Brand NameALLEGRETTO WAVE EYE-Q EXCIMER LASER
Generic NameOPHTHALMIC EXCIMER LASER SYSTEM
Product CodeLZS
Date Received2020-03-30
Model NumberNA
Catalog Number8065990739
Lot NumberNA
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerWAVELIGHT GMBH
Manufacturer AddressAM WOLFSMANTEL 5 ERLANGEN 91058 GM 91058


Patients

Patient NumberTreatmentOutcomeDate
101. Required No Informationntervention 2020-03-30

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