MAUDE Adverse Event Report: KARL STORZ SE & CO. KG HOPKINS TELESCOPE 6°, 11MM, 27.5CM

Model Number	26075AA
Medical Device Problem Codes	Poor Quality Image (1408); Dent in Material (2526)
Health Effect - Clinical Code	Insufficient Information (4580)
Type of Reportable Event	Malfunction
Event or Problem Description
It was reported that there is a blurred vision and dents on the stem.No negative impact in state of health reported.
Additional Manufacturer Narrative
The device in question was returned to the manufacturer.This information is reflected in section d9.The evaluation is anticipated, but not yet begun.The investigation will be performed by a designated karl storz employee.The event is filed under internal karl storz complaint id: (b)(4).
Additional Manufacturer Narrative
Result of investigation: during technical investigation the following was observed: the shaft of the optics is bent.There is mechanical damage (impact marks) to the optics shaft.The rod lens system is displaced due to the bent shaft and mechanical damage, which negatively affects imaging.A distinct shadow is visible at the top edge of the image, and the image is blurred in this area.Scratches can be seen at the distal end.The defects/damage found are not due to a manufacturing/production error but may be caused by improper clinical use or deviating, improper clinical reprocessing.All production-related quality checks were passed, and no non-conformities were identified in the device's manufacturing records.Appropriate warnings about the correct handling of the device and the product testing as well as precautions and warnings are included in the corresponding instructions for use.The event is filed under internal karl storz complaint id: (b)(4).

• Brand Name: HOPKINS TELESCOPE 6°, 11MM, 27.5CM
• Common Device Name: HOPKINS TELESCOPE 6°, 11MM, 27.5CM
• Manufacturer (Section D): KARL STORZ SE & CO. KG; dr.-karl-storz-strasse 34; tuttlingen, 78532 ; GM 78532
• Manufacturer (Section G): KARL STORZ SE & CO. KG; dr.-karl-storz-strasse 34; tuttlingen, 78532 ; GM 78532
• Manufacturer Contact: anja fair ; 2151 e grand ave; el segundo, CA 90245
• MDR Report Key: 23698008
• Report Number: 9610617-2025-02237
• Device Sequence Number: 9072124
• Product Code: GCJ
• UDI-Device Identifier: 04048551230060
• UDI-Public: 04048551230060
• Combination Product (Y/N): N
• Initial Reporter Country: IT
• PMA/510(K) Number: K223923
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Serviced by Third Party (Y/N): Unknown
• Reporter Type: Manufacturer
• Report Source: Foreign,Health Professional,User Facility,Company Representative
• Initial Reporter Occupation: Other Health Care Professional
• Type of Report: Initial,Followup
• Report Date (Section B): 02/03/2026

1 Device was Involved in the Event

1 Patient was Involved in the Event

• Is this an Adverse Event Report?: No
• Is this a Product Problem Report?: Yes
• Operator of Device: Health Professional
• Device Model Number: 26075AA
• Device Catalogue Number: 26075AA
• Was Device Available for Evaluation?: Device Returned to Manufacturer
• Date Returned to Manufacturer: 11/07/2025
• Is the Reporter a Health Professional?: Yes
• Type of Report(Section G): Thirty-Day
• Initial Date Received by Manufacturer: 11/19/2025
• Supplement Date Received by Manufacturer: Not provided
• Initial Report FDA Received Date: 12/02/2025
• Supplement Report FDA Received Date: 02/03/2026
• Was Device Evaluated by Manufacturer? (Y/N): Yes
• Is the Device Labeled for Single Use? (Y/N): No
• Is This a Single-Use Device that was Reprocessed and Reused on a Patient? (Y/N): No
• Usage of Device: Unknown
• Patient Sequence Number: 1
• Patient Sex: Unknown