FDA Adverse Event Injury Summary report: N

NATURALASE PIQO4

MDR report key: 7233380 · Received February 1, 2018

Report

Report Number
1720381-2018-00001
Event Type
Injury
Date Received
February 1, 2018
Report Date
February 1, 2018
Manufacturer
FOCUS MEDICAL, LLC.
Product Code
GEX
Adverse Event
Yes
Report Source
Distributor report
Reporter Location
CT, US
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

Narratives

Additional Manufacturer Narrative · 1

A LUMENIS HEALTHCARE PROFESSIONAL EVALUATED THE REPORTED EVENT DETAILS CONCLUDING:"SKIN APPEARED ABLATED IN PHOTO OVER AREA'S TREATED. ENERGY SETTINGS APPEARED TOO HIGH AND IRREGULAR PATTERN OBSERVED. DENSE FROSTING OBSERVED IN OTHER AREA'S OF ENDPOINT. PT TREATED WITH HYDROGEL CREAM AND IS RECOVERING". BASED ON INFORMATION ABOVE AN ADVERSE EVENT HAD OCCURRED. LUMENIS IS NOT THE MANUFACTURER OF THE PIQO4 WHICH WERE BEING USED DURING THIS PROCEDURE, LUMENIS IS FORWARDING THE INFORMATION OF THIS EVENT TO THE LEGAL MANUFACTURER, FOCUS MEDICAL FOR FURTHER INVESTIGATION AND CLOSING THIS COMPLAINT.

Description of Event or Problem · 1

A LUMENIS CLINICAL TRAINER REPORTED THAT ONE (1) PATIENT SUSTAINED BURNS ON HEAD AREA FOLLOWING TATTOO REMOVAL TREATMENT WITH A PIQO4 LASER.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
78566 NATURALASE PIQO4 NATURALASE PIQO4 GEX FOCUS MEDICAL, LLC. PIQO4

Patients

Seq Age Sex Outcome Treatment
1 Other