ILIGHT PRO IPL6000

MAUDE Adverse Event Report

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.

MAUDE Entry Details

Report Number3005855240-2016-00001
MDR Report Key5669917
Date Received2016-05-20
Date of Report2016-10-28
Date of Event2014-08-15
Date Facility Aware2014-08-15
Report Date2016-10-28
Date Reported to FDA2016-10-28
Date Reported to Mfgr2016-10-28
Date Mfgr Received2014-08-15
Device Manufacturer Date2012-09-17
Date Added to Maude2016-05-20
Event Key0
Report Source CodeDistributor report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag0
Reporter OccupationPATIENT
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer ContactMS. LETICIA BOOTH
Manufacturer Street81 HARTWELL AVE
Manufacturer CityLEXINGTON MA 02421
Manufacturer CountryUS
Manufacturer Postal02421
Manufacturer Phone7819953528
Manufacturer G1SHASER INC
Manufacturer CountryUS
Single Use3
Previous Use Code3
Event Type3
Type of Report0

Device Details

Brand NameILIGHT PRO IPL6000
Generic NameIPL6000
Product CodeONF
Date Received2016-05-20
Model NumberIPL6000
Catalog NumberIPL6000
Lot Number12091700160V
ID NumberNI
OperatorLAY USER/PATIENT
Device AvailabilityN
Device Age43 MO
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerSHASER INC
Manufacturer Address81 HARTWELL AVE LEXINGTON MA 02421 US 02421



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