FDA Adverse Event Injury Summary report: N

LIGHTSHEER ET

MDR report key: 1604445 · Received February 9, 2010

Report

Report Number
2914019-2010-00005
Event Type
Injury
Date Received
February 9, 2010
Date of Event
January 11, 2010
Report Date
February 9, 2010
Manufacturer
RH USA, INC.
Product Code
GEX
PMA / PMN Number
K003614
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
NY, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

AN EVALUATION OF THE SUBJECT DEVICE BY A LUMENIS TECHNICAL SPECIALIST CONCLUDED THE ROOT CAUSE OF THE REPORTED EVENT TO BE DEBRIS BUILD UP ON THE TREATMENT TIP AS A RESULT OF INSUFFICIENT CLEANING BY THE USER FACILITY IN CONTRADICTION TO PRODUCT LABELING.

Description of Event or Problem · 1

IT WAS REPORTED THAT TWO PTS SUSTAINED BURNS AFTER HAIR REMOVAL TREATMENT WITH A LIGHTSHEER ET LASER.

Devices

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

Patients

Seq Age Sex Outcome Treatment
1 43 YR