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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: GYRUS ACMI, INC. PK BUTTON (BOX OF 5); ELECTRODE, ELECTROSURGICAL, ACTIVE, UROLOGICAL

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GYRUS ACMI, INC. PK BUTTON (BOX OF 5); ELECTRODE, ELECTROSURGICAL, ACTIVE, UROLOGICAL Back to Search Results
Model Number 786500
Medical Device Problem Code Electrical /Electronic Property Problem (1198)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 01/14/2026
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
The investigation is ongoing.A supplemental report will be submitted when the investigation is completed or if additional information becomes available.
 
Event or Problem Description
It was reported the electrosurgical electrode had no function when activated.The issue occurred during a therapeutic transurethral resection of the prostate (terp) procedure that was completed with a similar device.There were no reports of patient harm.
 
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Brand Name
PK BUTTON (BOX OF 5)
Common Device Name
ELECTRODE, ELECTROSURGICAL, ACTIVE, UROLOGICAL
Manufacturer (Section D)
GYRUS ACMI, INC.
9600 louisiana avenue north
brooklyn park MN 55445
Manufacturer (Section G)
GYRUS ACMI, INC.
9600 louisiana avenue north
brooklyn park MN 55445
Manufacturer Contact
todd brill
800 west park drive
westborough, MA 01581
5082077661
MDR Report Key24303484
Report Number3011050570-2026-00159
Device Sequence Number9660825
Product Code FAS
UDI-Device Identifier00821925039520
UDI-Public00821925039520
Combination Product (Y/N)N
Initial Reporter StateNJ
Initial Reporter CountryUS
PMA/510(K) Number
K093181
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)N
Reporter Type Manufacturer
Report Source Health Professional,User Facility
Initial Reporter Occupation Nurse
Type of Report Initial,Followup,Followup
Report Date (Section B) 06/22/2026
1 Device was Involved in the Event
1 Patient was Involved in the Event
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Operator of Device Health Professional
Device Model Number786500
Device Lot NumberU2410002
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Initial
Initial Date Received by Manufacturer 01/14/2026
Supplement Date Received by Manufacturer06/12/2026
06/18/2026
Initial Report FDA Received Date02/10/2026
Supplement Report FDA Received Date06/18/2026
06/22/2026
Was Device Evaluated by Manufacturer? (Y/N) No
Date Device Manufactured11/12/2024
Is the Device Labeled for Single Use? (Y/N) Yes
Is This a Single-Use Device that was
Reprocessed and Reused on a Patient? (Y/N)
No
Usage of Device Initial
Patient Sequence Number1
Patient SexUnknown
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