FDA Adverse Event Malfunction Summary report: N

VIDEO URETERO-RENOSCOPE FLEX-XC1

MDR report key: 24561357 · Received March 10, 2026

Report

Report Number
1221826-2026-00492
Event Type
Malfunction
Date Received
March 10, 2026
Date of Event
February 20, 2026
Report Date
March 10, 2026
Manufacturer
KARL STORZ ENDOVISION
Product Code
FGB
UDI-DI
04048551428030
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 WAS REPORTED THAT LINES FLICKERING ACROSS THE SCREEN, AND EVENTUALLY TOOK OVER THE WHOLE SCREEN, THEN THE IMAGE DROPPED. ALL COMPLAINTS ON THIS ISSUE HAS BEEN WITH CLEARPETRA USING HIGH-PRESSURE IRRIGATION. NO NEGATIVE IMPACT IN STATE OF HEALTH REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
616764 VIDEO URETERO-RENOSCOPE FLEX-XC1 VIDEO URETERO-RENOSCOPE FLEX-XC1 FGB KARL STORZ ENDOVISION 091279-06 202506241 04048551428030

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown