VIDEO URETERO-RENOSCOPE FLEX-XC1
Report
- Report Number
- 1221826-2025-02207
- Event Type
- Malfunction
- Date Received
- December 3, 2025
- Date of Event
- November 10, 2025
- Report Date
- January 27, 2026
- Manufacturer
- KARL STORZ ENDOVISION
- Product Code
- FGB
- UDI-DI
- 04048551428023
- PMA / PMN Number
- K212458
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- NY, US
- Reporter Occupation
- OTHER HEALTH CARE PROFESSIONAL
- Health Professional
- Yes
Narratives
CONCLUSION SUMMARY: INVESTIGATIONAL ACTIVITIES SUGGEST MULTIPLE ROOT CAUSES COULD POTENTIALLY BE RELATED TO IMAGE QUALITY ISSUES. IN AN EFFORT TO FURTHER INVESTIGATE THE POTENTIAL ROOT CAUSES, WE HAVE INITIATED CAPA-25-0042. WE WILL CONTINUE TO TRACK AND TREND IMAGE QUALITY ISSUES. THIS EVENT IS FILED UNDER INTERNAL COMPLAINT ID (B)(4).
CONCLUSION SUMMARY: INVESTIGATIONAL ACTIVITIES SUGGEST MULTIPLE ROOT CAUSES COULD POTENTIALLY BE RELATED TO IMAGE QUALITY ISSUES. IN AN EFFORT TO FURTHER INVESTIGATE THE POTENTIAL ROOT CAUSES, WE HAVE INITIATED CAPA-25-0042. WE WILL CONTINUE TO TRACK AND TREND IMAGE QUALITY ISSUES. THIS EVENT IS FILED UNDER INTERNAL COMPLAINT (B)(4).
IT WAS REPORTED THAT THE TELESCOPE DIDN'T DISPLAY AN IMAGE. NO NEGATIVE IMPACT IN STATE OF HEALTH REPORTED.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 2845539 | VIDEO URETERO-RENOSCOPE FLEX-XC1 | VIDEO URETERO-RENOSCOPE FLEX-XC1 | FGB | KARL STORZ ENDOVISION | 091279-01 | 202503041 | 04048551428023 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | NA | Unknown |