FDA Adverse Event Injury Summary report: N

LIGHTSHEER ET

MDR report key: 1702077 · Received May 27, 2010

Report

Report Number
2914019-2010-00026
Event Type
Injury
Date Received
May 27, 2010
Date of Event
April 29, 2010
Report Date
May 27, 2010
Manufacturer
RH USA, INC
Product Code
GEX
PMA / PMN Number
K003614
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
IN, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

REASONABLE ATTEMPTS WERE MADE TO OBTAIN ADDITIONAL INFORMATION FROM THE USER FACILITY, HOWEVER, NONE WAS PROVIDED. A REVIEW OF SERVICE RECORDS FOR THE USER FACILITY CONCLUDED THAT NO SERVICE HAD BEEN PERFORMED BY LUMENIS SINCE 04/05/2005. A REVIEW OF THE REPORTED EVENT DETAILS CONCLUDED THAT INSUFFICIENT INFORMATION WAS PROVIDED TO DETERMINE A ROOT CAUSE. SHOULD ADDITIONAL INFORMATION BE REPORTED A FOLLOW UP MDR WILL BE FILED.

Description of Event or Problem · 1

IT WAS REPORTED THAT A PATIENT SUSTAINED SCARRING 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