VANQUISH

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 06 report with the FDA on 2013-11-29 for VANQUISH manufactured by Btl Industries Limited.

Event Text Entries

[4109926] Reported that a female pt treated by vanquish complained after the treatment of erythema in the treated area. The skin at this time appeared otherwise healthy and intact. The following day pt called the office and reported she had been to the emergency dept due to burns that had appeared in the treatment area. Pt was prescribed topical burn cream silvadene and oral antibiotics. The physician's office has reached out to the pt several times to follow-up. The pt has not returned their calls.
Patient Sequence No: 1, Text Type: D, B5


[11328657] Btl industries followed up with the physician's office to gather additional info. Per the physician's office the procedure on (b)(6) 2013 was conducted successfully with no malfunctions. Btl industries reviewed the system logs for the treatment date and confirmed that no system malfunction occurred.
Patient Sequence No: 1, Text Type: N, H10


MAUDE Entry Details

Report Number3005028741-2013-00002
MDR Report Key3504164
Report Source06
Date Received2013-11-29
Date of Report2013-11-28
Date of Event2013-10-25
Date Mfgr Received2013-10-30
Device Manufacturer Date2013-07-01
Date Added to Maude2013-12-09
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional3
Initial Report to FDA3
Report to FDA0
Event Location0
Manufacturer Street47 LORING DR.
Manufacturer CityFRAMINGHAM MA 01702
Manufacturer CountryUS
Manufacturer Postal01702
Manufacturer Phone8662851656
Manufacturer G1BTL INDUSTRIES LIMITED
Manufacturer Street30 PESHTERSKO SHOUSE BLVD
Manufacturer CityPLOVDIV 4002
Manufacturer CountryBU
Manufacturer Postal Code4002
Single Use3
Remedial ActionPM
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameVANQUISH
Product CodeIMJ
Date Received2013-11-29
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device AgeDA
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerBTL INDUSTRIES LIMITED
Manufacturer Address30 PESHTERSKO SHOUSE BLVD PLOVDIV 4002 BU 4002


Patients

Patient NumberTreatmentOutcomeDate
101. Required No Informationntervention 2013-11-29

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