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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: KARL STORZ SE & CO.KG 27005CA

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KARL STORZ SE & CO.KG 27005CA Back to Search Results
Model Number 27005CA
Medical Device Problem Code Poor Quality Image (1408)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Type of Reportable Event Malfunction
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).
 
Event or Problem Description
It was reported cloudy the scope was found to be blurry during inspection on assembly floor.No negative impact in state of health reported.
 
Additional Manufacturer Narrative
The affected device will be forwarded for further investigation by the manufacturer.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
27005CA
Common Device Name
27005CA
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 Key24283548
Report Number9610617-2026-00252
Device Sequence Number9862209
Product Code FAJ
UDI-Device Identifier04048551001073
UDI-Public04048551001073
Combination Product (Y/N)N
Initial Reporter StateMN
Initial Reporter CountryUS
PMA/510(K) Number
K243653
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 Number27005CA
Device Catalogue Number27005CA
Was Device Available for Evaluation? Device Returned to Manufacturer
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 01/21/2026
Supplement Date Received by Manufacturer03/25/2026
Initial Report FDA Received Date02/06/2026
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
Usage of Device Unknown
Patient Sequence Number1
Patient SexUnknown
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