FDA Adverse Event Malfunction Summary report: N

ENDOWRIST

MDR report key: 23504610 · Received November 8, 2025

Report

Report Number
2955842-2025-44586
Event Type
Malfunction
Date Received
November 8, 2025
Date of Event
October 14, 2025
Report Date
November 27, 2025
Manufacturer
INTUITIVE SURGICAL, INC
Product Code
NAY
UDI-DI
00886874119808
PMA / PMN Number
K214095
Removal / Correction Number
ISIFA2024-09-C
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
JA
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

A REVIEW OF CUSTOMER PROVIDED IMAGE WAS PERFORMED BY AN INTUITIVE SURGICAL INC., (ISI) ADVANCED FAILURE ANALYSIS (AFA) TEAM. FOLLOWING INFORMATION WAS PROVIDED : THE GRIP CABLE ON INSTRUMENT APPEARS TO BE BROKEN. INTUITIVE SURGICAL, INC. (ISI) HAS RECEIVED THE 8MM FENESTRATED BIPOLAR FORCEPS INSTRUMENT; HOWEVER, FAILURE ANALYSIS INVESTIGATIONS ARE UNDER PROGRESS. ADDITIONAL INFORMATION IS BEING GATHERED TO DETERMINE THE CONTRIBUTION OF THE DEVICE TO THE CUSTOMER REPORTED ISSUE.

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.

Description of Event or Problem · 0

IT WAS REPORTED THAT DURING A DA VINCI-ASSISTED SURGICAL PROCEDURE, THE 8MM FENESTRATED BIPOLAR FORCEPS INSTRUMENT WAS OBSERVED TO HAVE A BROKEN CABLE. THE PROCEDURE WAS COMPLETING AS PLANNED WITH NO REPORTED 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
171634 ENDOWRIST FENESTRATED BIPOLAR FORCEPS NAY INTUITIVE SURGICAL, INC 471205-17 K10240606 0481 00886874119808

Patients

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