| Brand Name | Moses Pulse |
| Common Device Name | Powered Laser Surgical Instrument |
| Manufacturer (Section D) |
| LUMENIS LTD |
| yokneam industrial park |
| hakidma st 6 |
| yokneam 20692 04 |
| IS 2069204 |
|
| Manufacturer (Section G) |
| LUMENIS LTD |
| yokneam industrial park |
| hakidm |
| yokneam 20692 04 |
|
IS
2069204
|
|
| Manufacturer Contact |
|
farshad
fahimi
|
| 4100 hamline avenue north |
| building c |
| saint paul, MN 55112
|
|
| MDR Report Key | 25196077 |
| Report Number | 2124215-2026-26559 |
| Device Sequence Number | 10473009 |
| Product Code |
GEX
|
| UDI-Device Identifier | 07290109145426 |
| UDI-Public | (01)07290109145426(11)190327(10)227 |
| Combination Product (Y/N) | N |
| Initial Reporter State | MT |
| Initial Reporter Country | US |
| PMA/510(K) Number | K170121 |
| Number of Events Summarized | 1 |
| Summary Report (Y/N) | N |
| Reporter Type |
Manufacturer
|
| Report Source |
Health Professional |
| Initial Reporter Occupation |
Other Health Care Professional
|
| Type of Report
| Initial,Followup,Followup |
| Report Date (Section B) |
09/14/2026 |
| 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 Number | GA-0006801 |
| Device Catalogue Number | GA-0006801 |
| Was Device Available for Evaluation? |
No
|
| Is the Reporter a Health Professional? |
Yes
|
| Was the Report Sent to FDA? |
No
|
| Type of Report(Section G) | Thirty-Day |
| Initial Date Received by Manufacturer | 04/22/2026 |
| Supplement Date Received by Manufacturer | 05/20/2026 08/21/2026
|
| Initial Report FDA Received Date | 05/16/2026 |
| Supplement Report FDA Received Date | 06/11/2026 09/14/2026
|
| Was Device Evaluated by Manufacturer? (Y/N) |
Yes
|
| Date Device Manufactured | 03/27/2019 |
| Is the Device Labeled for Single Use? (Y/N) |
No
|
| Usage of Device |
Reuse
|
| Patient Sequence Number | 1 |
| Patient Sex | Unknown |