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 |