FDA Adverse Event Other Summary report: N

PROFILE

MDR report key: 1615607 · Received February 16, 2010

Report

Report Number
2953696-2010-00010
Event Type
Other
Date Received
February 16, 2010
Date of Event
July 7, 2009
Report Date
July 16, 2009
Manufacturer
SCITON, INC.
Product Code
GEX
PMA / PMN Number
070388
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
NY, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

SCITON CLINICAL STAFF CONCLUDED THAT THE PROBABLE ROUTE CAUSE FOR THIS ADVERSE EVENT WAS MISTAKENLY TREATING FOR HAIR OVER A TATTOO WITH (B)(4). SCITON RECOMMENDS NOT TO TREAT PTS FOR HAIR OVER TATTOOED AREAS. INSTRUCTIONS FOR THIS CONTRAINDICATION ARE PROVIDED IN THE OPERATOR MANUAL FOR THIS DEVICE. THERE IS NO EVIDENCE THAT THERE WAS A DEVICE MALFUNCTION.

Description of Event or Problem · 1

A CLINICIAN PERFORMED A BBLS HAIR REMOVAL TREATMENT ON A (B)(4) TYPE III-IV PT AND REPORTED RECEIVING A CALL FROM A PT WHO REPORTED A WOUND IN THE PREVIOUSLY TATTOOED REGION. THE PT WAS TREATED WITH THE FOLLOWING BBL PROTOCOL PARAMETERS: 640 FILTER, 15 J/CM2, 20MS, 10 DEG C, 1 PASS. THE CLINICIAN DID NOT QUESTION THE FUNCTION OF THE BBLS HANDPIECE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 PROFILE BBLS GEX SCITON, INC. PROFILE NA

Patients

Seq Age Sex Outcome Treatment
1 NA