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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: LUMENIS LTD PULSE; POWERED LASER SURGICAL INSTRUMENT

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LUMENIS LTD PULSE; POWERED LASER SURGICAL INSTRUMENT Back to Search Results
Model Number GA-1008944
Medical Device Problem Code Smoking (1585)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 03/18/2026
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that the device made a burning smell.The device is down.There was no report of patient or procedure involvement.
 
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Brand Name
PULSE
Common Device Name
POWERED LASER SURGICAL INSTRUMENT
Manufacturer (Section D)
LUMENIS LTD
hakidma 6
yokneam 20692 04
IS  2069204
Manufacturer (Section G)
LUMENIS LTD
yokneam industrial park
hakidma st 6
yokneam 20692 04
IS   2069204
Manufacturer Contact
farshad fahimi
4100 hamline avenue north
building c
saint paul, MN 55112
MDR Report Key24837714
Report Number2124215-2026-19487
Device Sequence Number16007565
Product Code GEX
UDI-Device Identifier07290109145969
UDI-Public(01)07290109145969(11)181211(10)256
Combination Product (Y/N)N
Initial Reporter StateNJ
Initial Reporter CountryUS
PMA/510(K) Number
K170121
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)Unknown
Reporter Type Manufacturer
Report Source Company Representative
Initial Reporter Occupation Non-Healthcare 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 NumberGA-1008944
Device Catalogue NumberGA-1008944
Was Device Available for Evaluation? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 03/18/2026
Supplement Date Received by Manufacturer05/14/2026
Initial Report FDA Received Date04/09/2026
Supplement Report FDA Received Date06/05/2026
Date Device Manufactured12/11/2018
Is the Device Labeled for Single Use? (Y/N) No
Usage of Device Reuse
Patient Sequence Number1
Patient SexUnknown
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