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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: KARL STORZ SE & CO. KG TIPCAM 1 S 3D LAP, 0°

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KARL STORZ SE & CO. KG TIPCAM 1 S 3D LAP, 0° Back to Search Results
Model Number 26605AA
Medical Device Problem Codes Erratic or Intermittent Display (1182); Device Damaged Prior to Use (2284)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that "it was reported that during a robotic laparoscopic cholecystectomy procedure, the endoscope image flickered once.The team continued using the endoscope.There was no patient injury".No negative impact in state of health reported.
 
Additional Manufacturer Narrative
The affected device has been requested for investigation by the manufacturer.The device was not yet returned for investigation.The event is filed under internal karl storz complaint id: (b)(4).
 
Additional Manufacturer Narrative
E1: hospital name added.The event is filed under internal karl storz complaint id: (b)(4).
 
Additional Manufacturer Narrative
Additional information is provided in section d9 to reflect that the product was returned for evaluation.The investigation is not completed yet.The investigation results are pending.The event is filed under internal karl storz complaint id: (b)(4).
 
Additional Manufacturer Narrative
Device evaluation: accordingly, we would like to give a summary of our results regarding the reported issue.The evaluation results: the device was sent to the karl storz assessment and repair department for inspection.During the technical inspection, the error description provided by the customer, " endoscope image flickering ", could not be confirmed.During the technical inspection of the optics, a cut was found in the connecting cable, which may be the cause of the fault described by the customer.Furthermore, further damage to the optical system was identified, including reduced light output (54%) due to chemically damaged light guides, mechanical damage (dents and impact marks on the distal end), a scratched handle, a scratched shaft and outdated operating software.The damage identified is not attributable to a manufacturing or production fault but was caused by clinical use or clinical reprocessing.The above investigations did not reveal a root cause related to the labelling, the device, or its history.All production-related quality checks were passed, and no non-conformities were identified in the device's manufacturing records.The labelling was found to contain adequate instructions and warnings.The complaint history did not reveal any pickup in similar complaints; no trend was identified.In addition, we would like to call your attention to a warning in the corresponding instructions for use (300000265386) on page 6, 7, 8, 9 and 10.The event is filed under internal karl storz complaint id: (b)(4).
 
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Brand Name
TIPCAM 1 S 3D LAP, 0°
Common Device Name
TIPCAM 1 S 3D LAP, 0°
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 Key24032949
Report Number9610617-2026-00043
Device Sequence Number16076963
Product Code FGB
UDI-Device Identifier04048551347782
UDI-Public04048551347782
Combination Product (Y/N)N
Initial Reporter CountryUS
PMA/510(K) Number
K150525
Number of Events Summarized1
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
Type of Report Initial,Followup,Followup,Followup
Report Date (Section B) 04/03/2026
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 Number26605AA
Device Catalogue Number26605AA
Was Device Available for Evaluation? Device Returned to Manufacturer
Is the Reporter a Health Professional? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 12/17/2025
Supplement Date Received by Manufacturer01/12/2202
01/27/2026
04/01/2026
Initial Report FDA Received Date01/12/2026
Supplement Report FDA Received Date01/13/2026
02/19/2026
04/03/2026
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 Number1
Patient SexUnknown
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