VANQUISH

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a user facility report with the FDA on 2015-09-25 for VANQUISH manufactured by Btl Industries Limited.

Event Text Entries

[26758453] Btl followed up with the health care facility to gather additional information. Per the health care facility patient tolerated the treatment well. Burns are listed in the operator? S manual as a potential adverse effect. The patient's injury is healing well. The system logs were reviewed for the treatment dates and confirmed that no system malfunction occurred during the treatment dates. A f/u report will be made to the agency if and when new information is received about this case.
Patient Sequence No: 1, Text Type: N, H10


[26758454] It was reported that a female patient treated by vanquish to abdomen experienced second degree and third degree burns in the treated area. Patient underwent a surgical intervention.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number3005028741-2015-00004
MDR Report Key5104081
Report SourceUSER FACILITY
Date Received2015-09-25
Date of Report2015-09-25
Date of Event2015-05-26
Date Mfgr Received2015-08-28
Device Manufacturer Date2014-10-17
Date Added to Maude2015-09-25
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag0
Reprocessed and Reused Flag3
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer ContactMR. JAN ZARSKY
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
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameVANQUISH
Generic NameSHORTWAVE DIATHERMY
Product CodeIMJ
Date Received2015-09-25
Device AvailabilityN
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 2015-09-25

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