| Brand Name | HOPKINS TELESCOPE 30°, 5 MM, 29 CM |
| Common Device Name | HOPKINS TELESCOPE 30°, 5 MM, 29 CM |
| Manufacturer (Section D) |
| KARL STORZ SE & CO.KG |
| dr.karl-storz-strasse 34 |
| tuttlingen, deu 78523 2 |
| GM 785232 |
|
| Manufacturer (Section G) |
| KARL STORZ SE & CO.KG |
| dr.karl-storz-strasse 34 |
|
| tuttlingen, deu 78523 2 |
|
GM
785232
|
|
| Manufacturer Contact |
|
anja
fair
|
| 2151 e. grand avenue |
| el segundo, CA 90245
|
|
4242188247
|
|
| MDR Report Key | 24257639 |
| Report Number | 9610617-2026-00204 |
| Device Sequence Number | 8327228 |
| Product Code |
GCJ
|
| UDI-Device Identifier | 04048551092132 |
| UDI-Public | 04048551092132 |
| Combination Product (Y/N) | N |
| Initial Reporter State | NC |
| Initial Reporter Country | US |
| PMA/510(K) Number | K935279 |
| Number of Events Summarized | 1 |
| Summary Report (Y/N) | N |
| Serviced by Third Party (Y/N) | Unknown |
| Reporter Type |
Manufacturer
|
| Report Source |
Health Professional,User Facility,Company Representative |
| Initial Reporter Occupation |
Other Health Care Professional
|
| Type of Report
| Initial |
| Report Date (Section B) |
02/04/2026 |
| 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 | R26046BA |
| Device Catalogue Number | R26046BA |
| Was Device Available for Evaluation? |
Device Returned to Manufacturer
|
| Date Returned to Manufacturer | 01/12/2026 |
| Is the Reporter a Health Professional? |
Yes
|
| Type of Report(Section G) | Thirty-Day |
| Initial Date Received by Manufacturer | 01/13/2026 |
| Initial Report FDA Received Date | 02/04/2026 |
| Was Device Evaluated by Manufacturer? (Y/N) |
No
|
| 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 |