FASCIABLASTER

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2017-09-18 for FASCIABLASTER manufactured by Ashley Black/adb Interests.

Event Text Entries

[86763811] I began using the fasciablaster tools daily at the end of (b)(6), as directed. I used the original fasciablaster, the mini 2 and the face blaster. By (b)(6) i developed debilitating fatigue and nerve pain all over my body. I could not be out of bed for more than a few hours per day. I developed extreme emotionality that i never had before - the most intense depression, rage and anxiety alternating rapidly. I cried uncontrollably. Sounds and sudden movement caused extreme panic and feelings of distress. I felt as though my entire nervous system was on hypervigilance and i was unable to participate in my typical family or work commitments. The sense of malaise i felt was akin to a serious flu. I had hot flashes throughout the day and night and could not sleep through any night because of my extreme discomfort.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report NumberMW5072205
MDR Report Key6875997
Date Received2017-09-18
Date of Report2017-09-17
Date of Event2017-07-15
Date Added to Maude2017-09-19
Event Key0
Report Source CodeVoluntary report
Manufacturer LinkN
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Reporter OccupationPATIENT
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Single Use3
Previous Use Code3
Event Type3
Type of Report0

Device Sequence Number: 1

Brand NameFASCIABLASTER
Generic NameCOMPONENTS, EXERCISE
Product CodeIOD
Date Received2017-09-18
Model NumberFASCIABLASTER
Device AvailabilityN
Device Eval'ed by MfgrI
Device Sequence No1
Device Event Key0
ManufacturerASHLEY BLACK/ADB INTERESTS

Device Sequence Number: 2

Brand NameMINI2
Generic NameCOMPONENTS, EXERCISE
Product CodeIOD
Date Received2017-09-18
Device AvailabilityN
Device Eval'ed by MfgrI
Device Sequence No2
Device Event Key0
ManufacturerASHLEY BLACK/ADB INTERESTS

Device Sequence Number: 3

Brand NameFACEBLASTER
Generic NameCOMPONENTS, EXERCISE
Product CodeIOD
Date Received2017-09-18
Device AvailabilityN
Device Eval'ed by MfgrI
Device Sequence No3
Device Event Key0
ManufacturerASHLEY BLACK/ADB INTERESTS


Patients

Patient NumberTreatmentOutcomeDate
101. Deathisabilit 2017-09-18

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