FDA Adverse Event Other Summary report: N

LIGHTSHEER DUET

MDR report key: 1574965 · Received January 8, 2010

Report

Report Number
2914019-2010-00002
Event Type
Other
Date Received
January 8, 2010
Date of Event
December 3, 2009
Report Date
January 8, 2010
Manufacturer
RH USA, INC.
Product Code
GEX
PMA / PMN Number
K053628
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
HI, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

AN EVALUATION OF THE EVENT DETAILS BY A LUMENIS MEDICAL SUBJECT MATTER EXPERT CONCLUDED THAT THE TREATMENT PARAMETERS USED BY THE USER FACILITY WERE WITHIN THOSE IN THE SUBJECT DEVICE TRAINING MATERIALS AND THE COMMON PRACTICE FOR THE SUBJECT INDICATION. NO RELATED DEVICE MALFUNCTION WAS REPORTED. REASONABLE ATTEMPTS WERE MADE TO OBTAIN ADDITIONAL RELEVANT INFORMATION; HOWEVER, NON WAS PROVIDED BY THE USER FACILITY. SHOULD ADDITIONAL INFORMATION BE RECEIVED, A FOLLOW UP MDR WILL BE FILED.

Description of Event or Problem · 1

IT WAS REPORTED THAT A PATIENT SUSTAINED BLISTERS AND SCABBING TO THE BACK OF THE THIGH AFTER HAIR REMOVAL TREATMENT WITH A LIGHTSHEER DUET LASER. IT WAS FURTHER REPORTED THAT BIAFINE WAS PRESCRIBED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 LIGHTSHEER DUET OTHER: DIODE GEX RH USA, INC. LIGHTSHEER DUET NA

Patients

Seq Age Sex Outcome Treatment
1 31 YR