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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: INTUITIVE SURGICAL, INC ENDOWRIST; CLIP APPLIER, SMALL, HORIZON

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INTUITIVE SURGICAL, INC ENDOWRIST; CLIP APPLIER, SMALL, HORIZON Back to Search Results
Model Number 470401-06
Medical Device Problem Code Material Split, Cut or Torn (4008)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 02/09/2026
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
The instrument involved in this complaint has not been received and/or tested by failure analysis as of the date of this report.If the product is received and evaluated, a supplemental mdr will be submitted.
 
Event or Problem Description
It was reported that there was a broken cable with a da vinci product.The customer reported event has no report of patient injury.
 
Event or Problem Description
Refer to h11 for follow-up information.
 
Additional Manufacturer Narrative
Intuitive surgical, inc.(isi) did receive a da vinci product to perform failure analysis.The horizon small clip applier instrument was analyzed and found to have one broken grip cable at the proximal end in the housing.The grip cable was fully broken near the clamping pulley.The clamping pulleys did not exhibit signs of corrosion/residue that would have contributed to the broken cable.The complaint was confirmed by failure analysis.The probable root cause of cable breakage is attributed to damage to the cable through external collisions, during use, or during reprocessing.
 
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Brand Name
ENDOWRIST
Common Device Name
CLIP APPLIER, SMALL, HORIZON
Manufacturer (Section D)
INTUITIVE SURGICAL, INC
3410 central expressway
santa clara CA 95051
Manufacturer (Section G)
INTUITIVE SURGICAL, INC
3410 central expressway
santa clara CA 95051
Manufacturer Contact
izabel nielson
3410 central expressway
santa clara, CA 95051
4085232100
MDR Report Key24465325
Report Number2955842-2026-13194
Device Sequence Number18545627
Product Code NAY
UDI-Device Identifier00886874112670
UDI-Public(01)00886874112670(10)T10200611
Combination Product (Y/N)N
Initial Reporter CountryJA
PMA/510(K) Number
K150837
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source Other,Foreign,Health Professional
Initial Reporter Occupation Other Health Care Professional
Remedial Action Other
Type of Report Initial,Followup
Report Date (Section B) 04/10/2026
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 Number470401-06
Device Catalogue Number470401
Device Lot NumberT10200611 0033
Was Device Available for Evaluation? Device Returned to Manufacturer
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Initial
Initial Date Received by Manufacturer 02/08/2026
Supplement Date Received by Manufacturer03/18/2026
Initial Report FDA Received Date02/26/2026
Supplement Report FDA Received Date04/11/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured06/11/2020
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 Initial
If action reported to FDA under 21 USC 360i(g), list
FDA-assigned Recall Number or include a statement
N/A
Patient Sequence Number1
Concomitant Medical Products
and Therapy/Usage Dates
DA VINCI INSTRUMENTS AND ACCESSORIES
Patient SexUnknown
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