FDA Adverse Event Other Summary report: N

ELITE MPX

MDR report key: 3391047 · Received October 3, 2013

Report

Report Number
1222993-2013-00007
Event Type
Other
Date Received
October 3, 2013
Date of Event
August 29, 2013
Report Date
September 24, 2013
Manufacturer
CYNOSURE, INC.
Product Code
GEX
PMA / PMN Number
K034030
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
TW
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

PHYSICIAN REPORTED THAT A PATIENT RECEIVED A SCAR AFTER A TREATMENT FOR HAIR REMOVAL. PATIENT WAS SKIN TYPE III/IV. LASER WAS EVALUATED BY SERVICE AND FOUND TO BE OPERATING IN SPECIFICATION. POSSIBLE ROOT CAUSE IS USER ERROR DUE TO OVER TREATMENT. NO FURTHER INFORMATION IS AVAILABLE.

Description of Event or Problem · 1

PATIENT EXPERIENCED A SCAR AFTER HER THIRD TREATMENT FOR HAIR REMOVAL. DOCTOR REPORTED AN ACUTE POST-TREATMENT RESPONSE DURING COOLING. THIS INCIDENT OCCURRED IN (B)(6).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
499192 ELITE MPX DERMATOLOGY LASER SYSTEM GEX CYNOSURE, INC. ELITE

Patients

Seq Age Sex Outcome Treatment
1 Other