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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: KARL STORZ SE & CO. KG TIPCAM1 RUBINA 0°, OPAL1 NIR/ICG, 4K 3D

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KARL STORZ SE & CO. KG TIPCAM1 RUBINA 0°, OPAL1 NIR/ICG, 4K 3D Back to Search Results
Model Number 26616ACA
Medical Device Problem Code Optical Distortion (3000)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 02/04/2026
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
The affected device has been requested for investigation by the manufacturer.The device was not yet returned for investigation.Cross reference complaint id:(b)(4).The event is filed under internal karl storz complaint id: (b)(4).
 
Event or Problem Description
It was reported that, during a robotic laparoscopic prostatectomy, the endoscope's image was blurred and unfocused.It was exchanged with a new endoscope and the procedure was completed without further incident.The exchange resulted in a five minute delay.There was no patient injury.Cross reference mdr: 9610617-2026-00310.
 
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Brand Name
TIPCAM1 RUBINA 0°, OPAL1 NIR/ICG, 4K 3D
Common Device Name
TIPCAM1 RUBINA 0°, OPAL1 NIR/ICG, 4K 3D
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 Key24350022
Report Number9610617-2026-00311
Device Sequence Number13233713
Product Code OWN
UDI-Device Identifier04048551426180
UDI-Public04048551426180
Combination Product (Y/N)N
Initial Reporter CountryIT
PMA/510(K) Number
K212695
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 Health Care Professional
Type of Report Initial
Report Date (Section B) 02/16/2026
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 Number26616ACA
Device Catalogue Number26616ACA
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 02/06/2026
Initial Report FDA Received Date02/16/2026
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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