FDA Adverse Event Injury Summary report: N

LIGHTSHEER ET

MDR report key: 1612453 · Received February 19, 2010

Report

Report Number
2914019-2010-00008
Event Type
Injury
Date Received
February 19, 2010
Date of Event
January 3, 2008
Report Date
February 19, 2010
Manufacturer
RH USA, INC.
Product Code
GEX
PMA / PMN Number
K003614
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
UT, US
Reporter Occupation
PATIENT

Narratives

Additional Manufacturer Narrative · 1

NO RELATED SUBJECT DEVICE MALFUNCTION WAS REPORTED; THEREFORE NO INVESTIGATION OF THE DEVICE WAS PERFORMED. A REVIEW OF THE SERVICE RECORDS FOR THE SUBJECT DEVICE CONCLUDED THAT NO PREVENTATIVE MAINTENANCE HAD BEEN PERFORMED SINCE (B) (6) 2005 IN CONTRAINDICATION TO DEVICE LABELING REQUIREMENTS FOR ANNUAL SERVICE.

Description of Event or Problem · 1

IT WAS REPORTED THAT A PATIENT SUSTAINED FIRST AND SECOND DEGREE BURNS AND BLISTERS ON THE UNDERARMS AND BIKINI AREA AFTER HAIR REMOVAL TREATMENT WITH A LIGHTSHEER ET LASER. IT WAS FURTHER REPORTED THAT MEDICAL INTERVENTION WAS ADMINISTERED TO THE PATIENT AT ANOTHER MEDICAL FACILITY.

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 44 YR