FDA Adverse Event Malfunction Summary report: N

ENDOWRIST

MDR report key: 22548705 · Received July 18, 2025

Report

Report Number
2955842-2025-30814
Event Type
Malfunction
Date Received
July 18, 2025
Date of Event
May 20, 2025
Report Date
August 4, 2025
Manufacturer
INTUITIVE SURGICAL, INC
Product Code
NAY
UDI-DI
00886874119785
PMA / PMN Number
K214095
Removal / Correction Number
ISIFA2024-09-C
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
JA
Reporter Occupation
OTHER
Health Professional
N

Narratives

Additional Manufacturer Narrative · 0

INTUITIVE SURGICAL, INC. (ISI) RECEIVED THE DA VINCI PRODUCT TO PERFORM FAILURE ANALYSIS. THE PROGRASP FORCEPS INSTRUMENT WAS ANALYZED AND FOUND TO HAVE A BROKEN GRIP CABLE AT THE DISTAL END. THE COMPLAINT REGARDING A BROKEN CABLE WAS CONFIRMED BY FAILURE ANALYSIS.

Additional Manufacturer Narrative · 0

THE FOLLOWING FIELDS NEED TO BE CORRECTED FOR THE INITIAL MDR THAT WAS PREVIOUSLY SUBMITTED FOR THIS EVENT: B4. DATE OF THIS REPORT: 06/03/2025. G3. DATE RECEIVED BY MFR: 06/03/2025.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE CUSTOMER EXPERIENCED AN ISSUE WITH AN INTUITIVE PRODUCT. THE CUSTOMER REPORTED EVENT HAS NO REPORT OF PATIENT INJURY.

Description of Event or Problem · 0

REFER TO H11 FOR FOLLOW-UP INFORMATION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1419929 ENDOWRIST PROGRASP FORCEPS NAY INTUITIVE SURGICAL, INC 471093-11 K11240222 0064 00886874119785

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown DA VINCI INSTRUMENTS AND ACCESSORIES