FDA Adverse Event Malfunction Summary report: N

NIR HANDHELD CAMERA

MDR report key: 24644384 · Received March 19, 2026

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

Additional Manufacturer Narrative · 0

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.

Description of Event or Problem · 0

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