FDA Adverse Event Injury Summary report: N

LIGHTSHEER DUET

MDR report key: 1623562 · Received March 4, 2010

Report

Report Number
2914019-2010-00010
Event Type
Injury
Date Received
March 4, 2010
Date of Event
January 23, 2010
Report Date
March 4, 2010
Manufacturer
RH USA, INC.
Product Code
GEX
PMA / PMN Number
K053628
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
AZ, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

AN EVALUATION OF THE REPORTED, TREATMENT SETTINGS BY A LUMENIS MEDICAL SUBJECT MATTER EXPERT CONCLUDED THE PROBABLE ROOT CAUSE TO BE FAILURE TO LOWER ENERGY LEVELS FOR THE TREATMENT OF TANNED SKIN IN CONTRAINDICATION TO DEVICE LABELING.

Description of Event or Problem · 1

IT WAS REPORTED THAT A PT SUSTAINED A SECOND DEGREE BURN ON THE LEG AFTER HAIR REMOVAL TREATMENT WITH A LIGHTSHEER DUET LASER RESULTING IN A SCAR.

Devices

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

Patients

Seq Age Sex Outcome Treatment
1 32 YR