FDA Adverse Event Malfunction Summary report: N

VIDEO URETERO-RENOSCOPE FLEX-XC1

MDR report key: 24185071 · Received January 26, 2026

Report

Report Number
1221826-2026-00126
Event Type
Malfunction
Date Received
January 26, 2026
Date of Event
January 7, 2026
Report Date
January 26, 2026
Manufacturer
KARL STORZ ENDOVISION
Product Code
FGB
UDI-DI
04048551428023
PMA / PMN Number
K212458
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NH, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

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).

Description of Event or Problem · 0

IT HAS BEEN REPORTED: THROUGHOUT THE CASE THE SCOPE INTERMITTENTLY CUT OUT. THE SURGEON HAD TO WAIT FOR THE IMAGE TO COME BACK A FEW TIMES. NO NEGATIVE IMPACT IN STATE OF HEALTH REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
243299 VIDEO URETERO-RENOSCOPE FLEX-XC1 VIDEO URETERO-RENOSCOPE FLEX-XC1 FGB KARL STORZ ENDOVISION 091279-01 202510281 04048551428023

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown