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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: KARL STORZ SE & CO. KG TIPCAM1 RUBINA 30°, OPAL1 NIR/ICG, 4K 3D; Confocal Optical Imaging

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KARL STORZ SE & CO. KG TIPCAM1 RUBINA 30°, OPAL1 NIR/ICG, 4K 3D; Confocal Optical Imaging Back to Search Results
Model Number 26606BCA
Medical Device Problem Codes Circuit Failure (1089); Output Problem (3005); Insufficient Device Problem Information (3190)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
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
The following was reported: "on (b)(6) 2025, the hospital reported a malfunction.The initial fault symptom was yellowish images.On-site inspection observed yellow deposits at the light guide interface of the scope.After cleaning with the company's special frosted lens cleaning paste, the fault suddenly changed to the scope showing "unable to recognize the main unit" with no image.The symptom persisted after multiple tests.Returned to rc for detection and confirmed as a scope malfunction." no negative impact in state of health reported.
 
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Brand Name
TIPCAM1 RUBINA 30°, OPAL1 NIR/ICG, 4K 3D
Common Device Name
Confocal Optical Imaging
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 Key24373393
Report Number9610617-2026-00271
Device Sequence Number4942006
Product Code OWN
Combination Product (Y/N)N
Initial Reporter CountryUS
PMA/510(K) Number
K233333
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source Foreign,Health Professional,User Facility,Company Representative
Initial Reporter Occupation Other Health Care Professional
Type of Report Initial,Followup,Followup,Followup,Followup
Report Date (Section B) 09/28/2026
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 Number26606BCA
Device Catalogue Number26606BCA
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 01/23/2026
Supplement Date Received by Manufacturer05/05/2026
04/16/2026
05/12/2026
09/04/2026
Initial Report FDA Received Date02/17/2026
Supplement Report FDA Received Date05/08/2026
05/12/2026
05/12/2026
09/28/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
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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