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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: KARL STORZ SE & CO.KG ROBI METAL OUTER SHEATH

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KARL STORZ SE & CO.KG ROBI METAL OUTER SHEATH Back to Search Results
Model Number 38600
Medical Device Problem Code Sparking (2595)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that the forceps were sparking and smoking.Insulation has separated from the collar where it goes into the handle on all items.No negative impact in state of health reported.
 
Additional Manufacturer Narrative
The device will be forwarded to the manufacturer for further investigation.Should relevant additional information / investigation results become available, a supplemental medwatch report will be submitted unsolicited.This event is filed under internal complaint id (b)(4).
 
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Brand Name
ROBI METAL OUTER SHEATH
Common Device Name
ROBI METAL OUTER SHEATH
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 Key24257673
Report Number9610617-2026-00202
Device Sequence Number12843859
Product Code GEI
UDI-Device Identifier04048551328606
UDI-Public04048551328606
Combination Product (Y/N)N
Initial Reporter StateKY
Initial Reporter CountryUS
PMA/510(K) Number
K962030
Number of Events Summarized1
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 Number38600
Device Catalogue Number38600
Device Lot NumberVN03
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer01/29/2026
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 Date02/04/2026
Was Device Evaluated by Manufacturer? (Y/N) No
Is the Device Labeled for Single Use? (Y/N) No
Usage of Device Unknown
Patient Sequence Number1
Patient SexUnknown
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