FDA Adverse Event Injury Summary report: N

ACCURE LASER SYSTEM

MDR report key: 17741173 · Received September 13, 2023

Report

Report Number
3017786046-2023-00002
Event Type
Injury
Date Received
September 13, 2023
Date of Event
July 13, 2023
Report Date
September 13, 2023
Manufacturer
ACCURE ACNE, INC.
Product Code
GEX
PMA / PMN Number
K222109
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
TX, US
Reporter Occupation
117

Narratives

Additional Manufacturer Narrative · 0

A SERVICE TECHNICIAN VISITED THE SITE AND FOUND ONE OF FOUR TREATMENT LOCATIONS WAS DELIVERING HIGHER THAN EXPECTED POWER. THE REGION OF INTEREST (ROI) #4 WAS OUT OF POSITION AND HAD TO BE CORRECTED. ROI MISALIGNMENT WAS CAUSED BY EXCESSIVE HANDPIECE TIP MOVEMENT BY THE USER. FOLLOW-UP INFORMATION INDICATED THE PROVIDER DID NOT USE ALCOHOL AS THE FINAL STEP IN REMOVAL OF THE TOPICAL ANESTHETIC. IN ADDITION, PURACYN PLUS ANTIMICROBIAL SOLUTION WAS APPLIED PRIOR TO LASER ENERGY APPLICATION. THE ROI MISALIGNMENT CREATED A HIGHER-THAN-EXPECTED POWER RESULTING IN THE BLISTERING. THE ADDITION OF PURACYN PLUS AND POSSIBLE INCOMPLETE REMOVAL OF THE TOPICAL ANESTHETIC CAN BE A CONTRIBUTING FACTOR TO LOCALIZED THERMAL ABSORPTION OF ENERGY.

Description of Event or Problem · 0

ACCURE WAS NOTIFIED BY A PROVIDER THAT A PATIENT EXHIBITED BLISTERING AFTER TREATMENT. AT THE FOLLOW UP VISIT, ABOUT THREE WEEKS LATER, THE PATIENT PRESENTED WITH SCARRING. THE PROVIDER TREATED THE PATIENT WITH TWO DIFFERENT LASER TREATMENTS SPECIFICALLY TO RESOLVE POST INFLAMMATORY ERYTHEMA AND SCARRING.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
84272 ACCURE LASER SYSTEM ACNE LASER GEX ACCURE ACNE, INC. PFMS00004

Patients

Seq Age Sex Outcome Treatment
1 25 YR Female Required Intervention