FDA Adverse Event Malfunction Summary report: N

ENDOWRIST

MDR report key: 22651637 · Received July 29, 2025

Report

Report Number
2955842-2025-32026
Event Type
Malfunction
Date Received
July 29, 2025
Date of Event
April 29, 2025
Report Date
November 18, 2025
Manufacturer
INTUITIVE SURGICAL, INC
Product Code
NAY
UDI-DI
00886874112298
PMA / PMN Number
K220023
Removal / Correction Number
ISIFA2024-09-C
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
IN
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

THE INSTRUMENT INVOLVED IN THIS COMPLAINT HAS NOT BEEN RECEIVED AND/OR TESTED BY FAILURE ANALYSIS AS OF THE DATE OF THIS REPORT. IF THE PRODUCT IS RECEIVED AND EVALUATED, A SUPPLEMENTAL MDR WILL BE SUBMITTED.

Additional Manufacturer Narrative · 0

THE INSTRUMENT INVOLVED IN THIS COMPLAINT HAS BEEN RECEIVED AND TESTED BY FAILURE ANALYSIS. THE INSTRUMENT WAS FOUND TO HAVE A DAMAGED GRIP CABLE.

Additional Manufacturer Narrative · 0

CORRECTION(S): B3. WAS UPDATED FROM 07/09/2025 TO 04/29/2025 TO REFLECT THE RELATED RECORD AS THE SAME EVENT WAS REPORTED TWICE. H8. WAS UPDATED TO INITIAL USE OF DEVICE. ANNEX A - DEVICE PROB DESC 1 WAS UPDATED FROM A25 - NO APPARENT ADVERSE EVENT TO A090205 - IMAGE ORIENTATION INCORRECT. ANNEX F - HEALTH IMPACT DESC 1 WAS UPDATED FROM F24 - INSUFFICIENT HEALTH IMPACT INFORMATION TO F26 - NO HEALTH CONSEQUENCES OR IMPACT. RELATED REPORT NUMBER 1 (H10) WAS UPDATED TO 2955842-2025-24663.

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.

Description of Event or Problem · 0

REFER TO H11 FOR FOLLOW-UP INFORMATION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1161054 ENDOWRIST MONOPOLAR CURVED SCISSORS NAY INTUITIVE SURGICAL, INC 470179-19 K14240606 0719 00886874112298

Patients

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