BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    VIDEO URETERO-RENOSCOPE FLEX-XC1

    MDR report key: 24561547 · Received March 10, 2026

    Report

    Report Number
    1221826-2026-00506
    Event Type
    Malfunction
    Date Received
    March 10, 2026
    Date of Event
    February 25, 2026
    Report Date
    April 10, 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

    Additional Manufacturer Narrative · 0

    THE DEVICE WILL BE FORWARDED TO THE MANUFACTURER FOR FURTHER INVESTIGATION. SHOULD RELEVANT ADDITIONAL INFORMATION / INVESTIGATION RESULTS BECOME AVAILABLE, A SUPPLEMENTAL MEDWATCH REPORT WILL BE SUBMITTED UNSOLICITED. THIS EVENT IS FILED UNDER INTERNAL COMPLAINT ID (B)(4).

    Additional Manufacturer Narrative · 0

    INTERMITTENT IMAGE. THERMAL DAMAGE ON DISTAL TIP. BROKEN RIVETS ON VERTEBRAE, DEFLECTION OFF( 260 UP / 245 DOWN) AND TRACKING OFF. LIFTED WORKING CHANNEL. FURTHER ROOT CAUSE INVESTIGATION ACTIVITIES TO BE DOCUMENTED PER CAPA 25-0042. THIS EVENT IS FILED UNDER INTERNAL COMPLAINT ID_(B)(4).

    Description of Event or Problem · 0

    IT WAS REPORTED THAT THE SCOPE HAD NO SIGNAL LOST 10X DURING CASE.NO NEGATIVE IMPACT IN STATE OF HEALTH REPORTED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    481591 VIDEO URETERO-RENOSCOPE FLEX-XC1 VIDEO URETERO-RENOSCOPE FLEX-XC1 FGB KARL STORZ ENDOVISION 091279-01 202512051 04048551428023

    Patients

    Seq Age Sex Outcome Treatment
    1 NA Unknown