FDA Adverse Event Injury Summary report: N

MJOULE

MDR report key: 20185367 · Received September 10, 2024

Report

Report Number
2953696-2024-00038
Event Type
Injury
Date Received
September 10, 2024
Date of Event
August 9, 2024
Report Date
September 9, 2024
Manufacturer
SCITON INC.
Product Code
GEX
UDI-DI
00863249000329
PMA / PMN Number
K101916
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
GA, US
Reporter Occupation
117

Narratives

Additional Manufacturer Narrative · 0

ON 08/13/2024: SCITON CLINICIAL RN REVIEWED THE IMAGES AND SUSPECTS A COUPLE OF BLISTERS. SCITON CLINICAL RN WAS INFORMED BY THE CLINIC THAT THE PATIENT HAS BEEN PRESCRIBED CLOBETASOL, AND SILVADENE MEDICATIONS. ON 08/16/2024: THE SYSTEM WAS CHECKED BY SCITON SERVICE TO INVESTIGATE WHY THE MACHINE WOULD NOT START AT SAFE START PROTOCOL AS REPORTED BY THE SCITON CLINICAL TRAINER. THE SYSTEM WAS TURNED ON AND OFF MULTIPLE TIMES DURING SERVICE VISIT TO TRY AND DUPLICATE THE REPORTED ISSUE AT FLUENCE 5 J/CM2 AND 3MS PULSE WIDTH WITH THE 515 FILTER IN USER MODE. THE SERVICE ENGINEER COULD NOT DUPLICATE THE ISSUE. DEVICE WAS INSPECTED AND NO DEVICE ISSUES WERE FOUND DURING THE INSPECTION. ON 09/09/2024: SCTION CONTACTED THE CLINIC AND WAS INFORMED THAT THE PATIENT IS RECOVERING AND HEALING WELL.

Description of Event or Problem · 0

ON 08/12/2024: OWNER OF THE CLINIC CONTACTED SCITON REPRESENTATIVE REPORTING THAT THE PATIENT'S CHEST HAD BURN FOLLOWING MJOULE BBL HEROIC TRAINING ON (B)(6) 2024 WITH 515 NM FILTER. THE PATIENT IS A STAFF MEMBER (NURSE PRACTITIONER) WITH ALLEGEDLY SOME IMMUNOCOMPROMISED ISSUES WITH HER HEALTH.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2335659 MJOULE POWERED LASER SURGICAL INSTRUMENT GEX SCITON INC. MJOULE 52508 00863249000329

Patients

Seq Age Sex Outcome Treatment
1 NA Female Required Intervention