inforMED
InjuryHJB

VERION REFERENCE UNIT

Received Jun 26, 2015 · Event occurred Jun 25, 2014

Report 3010300699-2015-00506 · MDR key 4871813

Device

Generic name

Keratometer, Pupillometer

Model number

X-RUS

Catalog number

8065998240

Lot number

ASKU

Product problems

  • Therapeutic or Diagnostic Output Failure

Patient

Not reported

  • Therapeutic Effects, Unexpected

Narrative

Additional Manufacturer Narrative

INVESTIGATION, INCLUDING ROOT CAUSE ANALYSIS, IS IN PROGRESS. A SUPPLEMENTAL MDR WILL BE FILED AS NECESSARY IN ACCORDANCE WITH 21 CFR 803.56 WHEN ADDITIONAL REPORTABLE INFORMATION BECOMES AVAILABLE. (B)(4).

Additional Manufacturer Narrative

NO TECHNICAL ROOT CAUSE COULD BE DETERMINED, BASED ON THE INFORMATION PROVIDED. CONTRIBUTING FACTORS FOR REPORTED ISSUE COULD BE ATTRIBUTED TO A POOR DIAGNOSTIC IMAGE, USE OF A NON OPTIMIZED FORMULA DURING PLANNING, OR INCORRECT PATIENT DATA ENTRY. THE MANUFACTURER INTERNAL REFERENCE NUMBER IS: (B)(4).

Description of Event or Problem

A NURSE REPORTED A CASE OF A TORIC INTRAOCULAR LENS EXPLANTED, AND INDICATED A DIAGNOSTIC CALCULATION ERROR CREATED AN UNEXPECTED REFRACTIVE OUT-COME. UPON ADDITIONAL FOLLOW UP, THE REPORTER WAS UNWILLING TO PROVIDE ANY ADDITIONAL INFORMATION.

Remedial action

  • Other