MAUDE MDR 3245112

MDR report key
3245112
Report number
2954354-2013-00001
Event key
0
Event type
3
Date of event
2012-12-14
Date received
2013-01-11
Adverse event
0
Product problem
3
Patients in event
0
Reporter occupation
403
Health professional
3
Initial report to FDA
3
Event location
3

Manufacturer Contact#

Contact
MS RENEE LIERLY
Address
3240 BAYSHORE BLVD BRISBANE CA 94005 US
Phone
415-415-4156
Report source
M
Manufacturer link flag
Y

Devices#

Seq, Brand, Generic table
SeqBrandGenericManufacturerProduct codeModelCatalogLotPMA510(k)ImplantEvaluatedAvailability
1TRUSCULPTCUTERA, INC.PBXNANANAY Y

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
12013-01-110

Event Narratives#

D

Patient 1

COATING FAILURE OF TREATMENT SURFACE ON HANDPIECE. DEVICE OPERATOR USED THE DEVICE TO TREAT SELF. THE COATING FAILURE CAUSED A SMALL BURN THAT HAS HEALED WITHOUT MEDICAL INTERVENTION.

N

Patient 1

.