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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: GYRUS ACMI, INC. SOLTIVE PREMIUM SUPERPULSED LASER SYSTEM; POWERED LASER SURGICAL INSTRUMENT

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GYRUS ACMI, INC. SOLTIVE PREMIUM SUPERPULSED LASER SYSTEM; POWERED LASER SURGICAL INSTRUMENT Back to Search Results
Model Number TFL-PLS
Medical Device Problem Code Overheating of Device (1437)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Type of Reportable Event Malfunction
Event or Problem Description
It was observed that during the device evaluation, the powered laser surgical instrument had burn marks on rear panel and could smell burning.There was no patient involvement.
 
Additional Manufacturer Narrative
The device was returned to olympus for inspection.A root cause could not be identified.Based on the results of the investigation, it is likely the root cause was power-related overheating, indicated by a burning odor and burn marks on the rear panel.Should additional relevant information become available, a supplemental report will be submitted.Olympus will continue to monitor field performance for this device.
 
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Brand Name
SOLTIVE PREMIUM SUPERPULSED LASER SYSTEM
Common Device Name
POWERED LASER SURGICAL INSTRUMENT
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 Key24929275
Report Number3011050570-2026-00427
Device Sequence Number10652657
Product Code GEX
UDI-Device Identifier00821925044111
UDI-Public00821925044111
Combination Product (Y/N)N
Initial Reporter CountryCA
PMA/510(K) Number
K242191
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)N
Reporter Type Manufacturer
Report Source Foreign,Company Representative
Initial Reporter Occupation Non-Healthcare Professional
Type of Report Initial
Report Date (Section B) 04/20/2026
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 Other
Device Model NumberTFL-PLS
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer08/06/2025
Type of Report(Section G)Initial
Initial Date Received by Manufacturer 03/27/2026
Initial Report FDA Received Date04/20/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Is This a Single-Use Device that was
Reprocessed and Reused on a Patient? (Y/N)
No
Usage of Device Reuse
Patient Sequence Number1
Patient SexUnknown
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