NIR HANDHELD CAMERA
Report
- Report Number
- 2955842-2026-16558
- Event Type
- Malfunction
- Date Received
- March 19, 2026
- Date of Event
- May 29, 2025
- Report Date
- March 19, 2026
- Manufacturer
- SCHOELLY FIBEROPTIC GMBH
- Product Code
- GCJ
- PMA / PMN Number
- K221591
- Removal / Correction Number
- N/A
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- FL, US
- Reporter Occupation
- 003
Narratives
INTUITIVE SURGICAL, INC. (ISI) DID NOT RECEIVE THE DA VINCI PRODUCT WITH AN ALLEGED ISSUE TO PERFORM FAILURE ANALYSIS. ALTHOUGH THE COMPLAINT WAS NOT CONFIRMED BY FAILURE ANALYSIS SINCE THE PRODUCT WAS NOT RETURNED, THE INFORMATION GATHERED INDICATES THAT THE DEVICE MAY HAVE CONTRIBUTED TO THE CUSTOMER REPORTED ISSUE.
IT WAS REPORTED THAT DURING A DA VINCI-ASSISTED SURGICAL PROCEDURE, THE LIGHT CORD FOR THE NEAR INFRARED (NIR) HANDHELD CAMERA WAS LEFT ON THE SIDE OF THE BED AND BURNT A HOLE THROUGH THE DRAPES AND BED. THE PROCEDURE WAS COMPLETED WITH NO REPORTED INJURY. ISI FOLLOWED UP WITH THE INITIAL REPORTER AND OBTAINED THE FOLLOWING ADDITIONAL INFORMATION: THE INITIAL REPORTER CONFIRMED THAT THERE WAS NO INJURY/HARM TO THE PATIENT STAFF.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 698426 | NIR HANDHELD CAMERA | CAMERA SYSTEM, NIR FI LIGHT SOURCE | GCJ | SCHOELLY FIBEROPTIC GMBH | 470655-01 | N/A |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | NA | Unknown | DA VINCI INSTRUMENTS AND ACCESSORIES |