FDA Adverse Event Injury Summary report: N

CCU,MODULAR,IMAGE1S 4U, CONNECT, INTL,CE

MDR report key: 24476449 · Received February 27, 2026

Report

Report Number
2020550-2026-00403
Event Type
Injury
Date Received
February 27, 2026
Date of Event
February 11, 2026
Report Date
February 27, 2026
Manufacturer
KARL STORZ SE & CO. KG
Product Code
FET
Adverse Event
Yes
Product Problem
Yes
Report Source
Distributor report
Reporter Location
NL
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

THE AFFECTED DEVICE HAS BEEN REQUESTED FOR INVESTIGATION BY THE MANUFACTURER. DEVICE WAS NOT RETURNED AT THE TIME OF MDR SUBMISSION. THE EVENT IS FILED UNDER INTERNAL KARL STORZ COMPLAINT ID: (B)(4).

Description of Event or Problem · 0

IT WAS REPORTED THAT THE PROBLEM OCCURRED DURING A SENTINAL NODE PROCEDURE, WHERE A RUBINA LENS, NIR/ICG EXOSKOP 90°, TH020 WAS MOUNTED ON THE CAMERA HEAD. DURING THE PROCEDURE, THE WERE COMMUNICATION PROBLEM BETWEEN THE VIDEO PROCESSOR AND THE RUBINA LIGHT SOURCE. THIS CONNECTION IS NECESSARY TO OPERATE THE ICG FUNCTION (OPAL). THIS FUNCTION WAS GRAYED OUT AND THEREFORE UNAVAILABLE. THEY RETRIEVED A COMPLETE SET FROM ANOTHER OR BECAUSE MOVING THE PATIENT WASN'T AN OPTION. THIS SET HAD THE EXACT SAME PROBLEM THE NETWORK CONNECTION WAS DOWN. TO SOLVE THIS PROBLEM TOOK TOO LONG, AND THE SURGEON DECIDED TO PROCEED WITHOUT AN ICG. A TYPE OF BLUE INK WAS USED TO ALLOW THE PROCEDURE TO PROCEED. THIS "INK" HAS REMAINED IN THE PATIENT FOR SEVERAL YEARS, WHICH IS UNDESIRABLE. APPARENTLY, THERE WAS SOMETHING WRONG WITH THE TIME DISPLAY IN BOTH THE VIDEO PROCESSOR AND THE LIGHT SOURCE. THEY HAD TO LOG IN TO BOTH DEVICES TO SYNCHRONIZE THEM. THE EVENT IS RELATED TO (B)(4). DUE TO THIS UNPLANNED USING OF THE INK AND THE REMAINING IN PATIENTS BODY THE CASE IS DEEMED REPORTABLE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
110972 CCU,MODULAR,IMAGE1S 4U, CONNECT, INTL,CE CCU,MODULAR,IMAGE1S 4U, CONNECT, INTL,CE FET KARL STORZ SE & CO. KG TC201

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown Other