BELIFU SM9126 TENS

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2020-02-10 for BELIFU SM9126 TENS manufactured by Hong Qiangxing (shen Zhen) Electronics Limited.

Event Text Entries

[179406099] Skin burned by the tens electrodes!!!! I. We are reporting unlawful sales of medical products on the internet; the reported device being sold on (b)(6) does not meet the specifications in the 510 (k) premarket submission; the reported device is being sold on (b)(6) before the 510 (k) clearance is granted. The reported (b)(6) seller shenzhen huayan e-commerce co. , ltd does not register their establishment on fda. Ii. Information about the seller, product, manufacturer which are being reported; product and seller? S information on (b)(6). Product page link from (b)(6). Seller name on (b)(6), brand name: belifu. Seller? S company name: shenzhen huayan e-commerce co. , ltd. One primary id number from photos of product reviews? (b)(4)? Please refer to the link of review: (b)(6); manufacturer? S information from fda? Https://www. Accessdata. Fda. Gov/scripts/cdrh/cfdocs/cfrl/rl. Cfm? Start_search=1&showlist+1&establishmentname=? Num=&statename=&countryname=? Istrationnumber=3010402752&owneroperatornumber=&owneroperatorname=&productcode=&devicename=&propietaryname=&establishmenttype=&pagenum=10&sortcolumn=establishmentname20%25asc. Device foreign manufacturer: hong qiangxing (shen zhen) electronics limited 4f, (b)(4). Device foreign manufacturer registration number (dev#): (b)(4). Manufacturer? S legal representative: (b)(4)- all 510 (k) numbers owned by the manufacturer: k 121719, k 133979, k 133108, k 183154, k 171821; product information from gudidi? Https://accessgudid. Nlm. Nih. Gov/devices/00321911080500. Brand name: belifu. Version or model: tens. Primary di number: (b)(4). Fda premarket submission number: k121719. Company name: hong qiangxing (shen zhen) electronics limited; product specifications from 510 (k) summary: https://www. Accessdata. Fda,gov/cdrh_docs/pdf12/k 121719. Pdf. Iii. Evidences regarding the unlawful sales of medical products on the internet; (b)(6) seller shenzhen huayane e-commerce co. , ltd have not registered facility on fda. All medical device establishments, such as manufacturers, distributors, repackagers and relabers, and foreign firms, are required to register their establishment and list their generic product with the fda. This requirement is applicable for all medical devices, even those devices that fall into a generic category of exempted class i devices or class ii 510 (k) premarket exempt devices; the reported device being sold on (b)(6) does not meet the specifications in the 510 (k) premarket submission. As you may see the product, which is selling now on (b)(6), is tested with 190? S max pulse width while the 510 (k) summary for k 121719 clearly state that the max pulse width is 100? S. In other words, the max pulse width for this product is almost twice than the limitation in k 121719 510(k) summary. Iv. Plan of action proposed; please check randomly on the seller? S (b)(6) inventory to see whether the specifications of the products being sold are consistent with 510 (k) summary. Product page link from (b)(6). Ask (b)(6) for cooperation to check whether the seller belifu (shenzhen huayan e-commerce co. , ltd) has already had facility registered on fda; fda team at us customs should investigate products and ask for recall for illegal products. The manufacturer uses (a) company name hong qiangxing electronics and product name mini massager and body massager to make customer clearance; please alert (b)(6) to suspend illegal product sales to keep american consumers safe. Fda safety report id # (b)(4).
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report NumberMW5092912
MDR Report Key9694283
Date Received2020-02-10
Date of Report2020-02-06
Date of Event2019-10-12
Date Added to Maude2020-02-11
Event Key0
Report Source CodeVoluntary report
Manufacturer LinkN
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Reporter OccupationOTHER HEALTH CARE PROFESSIONAL
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameBELIFU
Generic NameSTIMULATOR, NERVE, TRANSCUTANEOUS, FOR PAIN RELIEF
Product CodeGZJ
Date Received2020-02-10
Model NumberSM9126
Catalog NumberTENS
Lot Number(32)191108(30)02025
OperatorHEALTH PROFESSIONAL
Device AvailabilityY
Device Eval'ed by MfgrI
Device Sequence No1
Device Event Key0
ManufacturerHONG QIANGXING (SHEN ZHEN) ELECTRONICS LIMITED


Patients

Patient NumberTreatmentOutcomeDate
101. Other 2020-02-10

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