MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2016-05-20 for ILIGHT PRO IPL6000 manufactured by Shaser Inc.
Report Number | 3005855240-2016-00001 |
MDR Report Key | 5669917 |
Date Received | 2016-05-20 |
Date of Report | 2016-10-28 |
Date of Event | 2014-08-15 |
Date Facility Aware | 2014-08-15 |
Report Date | 2016-10-28 |
Date Reported to FDA | 2016-10-28 |
Date Reported to Mfgr | 2016-10-28 |
Date Mfgr Received | 2014-08-15 |
Device Manufacturer Date | 2012-09-17 |
Date Added to Maude | 2016-05-20 |
Event Key | 0 |
Report Source Code | Distributor report |
Manufacturer Link | Y |
Number of Patients in Event | 0 |
Adverse Event Flag | 3 |
Product Problem Flag | 3 |
Reprocessed and Reused Flag | 0 |
Reporter Occupation | PATIENT |
Health Professional | 3 |
Initial Report to FDA | 3 |
Report to FDA | 3 |
Event Location | 3 |
Manufacturer Contact | MS. LETICIA BOOTH |
Manufacturer Street | 81 HARTWELL AVE |
Manufacturer City | LEXINGTON MA 02421 |
Manufacturer Country | US |
Manufacturer Postal | 02421 |
Manufacturer Phone | 7819953528 |
Manufacturer G1 | SHASER INC |
Manufacturer Country | US |
Single Use | 3 |
Previous Use Code | 3 |
Event Type | 3 |
Type of Report | 0 |
Brand Name | ILIGHT PRO IPL6000 |
Generic Name | IPL6000 |
Product Code | ONF |
Date Received | 2016-05-20 |
Model Number | IPL6000 |
Catalog Number | IPL6000 |
Lot Number | 12091700160V |
ID Number | NI |
Operator | LAY USER/PATIENT |
Device Availability | N |
Device Age | 43 MO |
Device Eval'ed by Mfgr | R |
Device Sequence No | 1 |
Device Event Key | 0 |
Manufacturer | SHASER INC |
Manufacturer Address | 81 HARTWELL AVE LEXINGTON MA 02421 US 02421 |