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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: GYRUS ACMI, INC. SOLTIVE PRO SUPERPULSED LASER SYSTEM

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GYRUS ACMI, INC. SOLTIVE PRO SUPERPULSED LASER SYSTEM Back to Search Results
Model Number TFL-SLS
Medical Device Problem Code Communication or Transmission Problem (2896)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 02/02/2026
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 laser system's wireless pedal did not work, as exhibited by error 139.There were no reports of patient involvement.
 
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Brand Name
SOLTIVE PRO SUPERPULSED LASER SYSTEM
Common Device Name
SOLTIVE PRO SUPERPULSED LASER SYSTEM
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 Key24380810
Report Number3011050570-2026-00188
Device Sequence Number10490607
Product Code GEX
UDI-Device Identifier00821925044135
UDI-Public00821925044135
Combination Product (Y/N)N
Initial Reporter CountrySZ
PMA/510(K) Number
K242191
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)Unknown
Reporter Type Manufacturer
Report Source Foreign,User Facility
Initial Reporter Occupation Other Health Care Professional
Type of Report Initial,Followup
Report Date (Section B) 06/05/2026
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 NumberTFL-SLS
Was Device Available for Evaluation? Yes
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Initial
Initial Date Received by Manufacturer 02/02/2026
Supplement Date Received by Manufacturer06/03/2026
Initial Report FDA Received Date02/18/2026
Supplement Report FDA Received Date06/05/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Is the Device Labeled for Single Use? (Y/N) No
Is This a Single-Use Device that was
Reprocessed and Reused on a Patient? (Y/N)
No
Usage of Device Unknown
Patient Sequence Number1
Patient SexUnknown
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