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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: KARL STORZ SE & CO.KG HOPKINS TELESCOPE 30°, 5 MM, 29 CM

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KARL STORZ SE & CO.KG HOPKINS TELESCOPE 30°, 5 MM, 29 CM Back to Search Results
Model Number 26046BA
Medical Device Problem Code Poor Quality Image (1408)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 01/15/2026
Type of Reportable Event Malfunction
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).
 
Event or Problem Description
It was reported that the telescope had a blurry and cloudy vision.No negative impact in state of health reported.
 
Additional Manufacturer Narrative
The device will not 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
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 Key24261939
Report Number9610617-2026-00228
Device Sequence Number9575050
Product Code GCJ
UDI-Device Identifier04048551092132
UDI-Public04048551092132
Combination Product (Y/N)N
Initial Reporter StateMN
Initial Reporter CountryUS
PMA/510(K) Number
K221004
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,Followup
Report Date (Section B) 04/07/2026
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 Number26046BA
Device Catalogue Number26046BA
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 01/15/2026
Supplement Date Received by Manufacturer04/02/2026
Initial Report FDA Received Date02/04/2026
Supplement Report FDA Received Date04/07/2026
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 Number1
Patient SexUnknown
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