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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: KARL STORZ SE & CO. KG TIPCAM 1 S 3D LAP, 30°; Resectoscope

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KARL STORZ SE & CO. KG TIPCAM 1 S 3D LAP, 30°; Resectoscope Back to Search Results
Model Number 26605BA
Medical Device Problem Codes Fracture (1260); Insufficient Device Problem Information (3190)
Health Effect - Clinical Code Insufficient Information (4580)
Date of Event 01/30/2026
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.The event is filed under internal karl storz complaint id: (b)(4).
 
Event or Problem Description
It was reported that the device broke during surgery.No negative impact in state of health reported.
 
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Brand Name
TIPCAM 1 S 3D LAP, 30°
Common Device Name
Resectoscope
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 Key24369342
Report Number9610617-2026-00317
Device Sequence Number9773340
Product Code FJL
Combination Product (Y/N)N
Initial Reporter CountryUS
PMA/510(K) Number
K221893
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source Foreign,Health Professional,Company Representative
Initial Reporter Occupation Other Health Care Professional
Type of Report Initial,Followup,Followup
Report Date (Section B) 09/29/2026
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 Number26605BA
Device Catalogue Number26605BA
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? No
Was the Report Sent to FDA? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 02/02/2026
Supplement Date Received by Manufacturer05/05/2026
09/04/2026
Initial Report FDA Received Date02/17/2026
Supplement Report FDA Received Date06/01/2026
09/29/2026
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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