MAUDE Adverse Event Report: ALMA LASERS LTD. ALMA DIODE TABLETOP LASER; ALMA DIODE 1470

Model Number	1
Medical Device Problem Code	Insufficient Device Problem Information (3190)
Health Effect - Clinical Code	Burn(s) (1757)
Date of Event	05/06/2025
Type of Reportable Event	Serious Injury
Event or Problem Description
Burn on chin post treatment.

• Brand Name: ALMA DIODE TABLETOP LASER
• Common Device Name: ALMA DIODE 1470
• Manufacturer (Section D): ALMA LASERS LTD.; 18 haharash street; north industrial park, ceasarea 30798 95; IS 3079895
• MDR Report Key: 22179312
• Report Number: 3004450661-2025-00014
• Device Sequence Number: 15887750
• Product Code: GEX
• UDI-Device Identifier: 17290110121317
• UDI-Public: 17290110121317
• Combination Product (Y/N): N
• Initial Reporter State: TX
• Initial Reporter Country: US
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Serviced by Third Party (Y/N): Unknown
• Reporter Type: Importer
• Initial Reporter Occupation: Other
• Type of Report: Initial
• Report Date (Section B): 06/10/2025
• Report Date (Section F): 06/10/2025

1 Device was Involved in the Event

1 Patient was Involved in the Event

• Is this an Adverse Event Report?: Yes
• Is this a Product Problem Report?: No
• Device Model Number: 1
• Device Catalogue Number: AALP03121311
• Was Device Available for Evaluation?: No
• Was the Report Sent to FDA?: Yes
• Distributor Facility Aware Date: 05/13/2025
• Event Location: Outpatient Treatment Facility
• Date Report to Manufacturer: 06/11/2025
• Initial Date Received by Manufacturer: Not provided
• Initial Report FDA Received Date: 06/10/2025
• Is This a Single-Use Device that was Reprocessed and Reused on a Patient? (Y/N): No
• Patient Sequence Number: 1
• Outcome Attributed to Adverse Event: Other
• Patient Age: 40 YR
• Patient Sex: Female
• Date Report Sent to FDA: 06/10/2025