FDA Adverse Event Malfunction Summary report: N

8000229

MDR report key: 22737893 · Received August 7, 2025

Report

Report Number
22737893
Event Type
Malfunction
Date Received
August 7, 2025
Date of Event
June 9, 2025
Report Date
June 25, 2025
Manufacturer
LASER PERIPHERALS, LLC
Product Code
GEX
Product Problem
Yes
Report Source
User Facility report
Reporter Location
IA
Reporter Occupation
NURSE
Health Professional
Yes

Narratives

Description of Event or Problem · 0

DURING HOLMIUM LASER CASE THE LASER FIBER BROKE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2218838 8000229 POWERED LASER SURGICAL INSTRUMENT GEX LASER PERIPHERALS, LLC 8000229 DB25006

Patients

Seq Age Sex Outcome Treatment
1 53 YR Male