inforMED
MalfunctionCAL

FIVE S 3.5X65, STERILE, FOR SINGLE USE

Received Mar 18, 2024 · Event occurred Feb 16, 2024

Report 9610617-2024-00073 · MDR key 18926516

Device

Generic name

Flexible Video Intubation Laryngoscope,

Model number

091361-06

Catalog number

091361-06

Lot number

500098519

Product problems

  • No Display/Image
  • Optical Distortion
  • No Display/Image
  • Optical Distortion

Patient

NA · Unknown

  • No Clinical Signs, Symptoms or Conditions
  • No Clinical Signs, Symptoms or Conditions

Narrative

Additional Manufacturer Narrative

THE AFFECTED DEVICE HAS BEEN REQUESTED FOR INVESTIGATION BY THE MANUFACTURER. DEVICE WAS NOT YET RETURNED FOR INVESTIGATION. THE EVENT IS FILED UNDER INTERNAL KARL STORZ COMPLAINT ID: (B)(4).

Description of Event or Problem

IT WAS REPORTED ON FEBURARY 27, 2023 THAT :DURING A VETERINARY INTERVENTION, IMAGE FAILURE 5 MINUTES INTO THE PROCEDURE. NO HARM TO PATIENT, USER OR THIRD PARTIES. FURTHER INFORMATION RECEIVED ON THE MARCH 14, 2024 THAT THE BRONCHOSCOPY HAD TO BE ABORTED AND THE LUNG WASH WAS PERFORMED BLIND. DUE TO THE ADDITIONAL INFORMATION AND THE MENTIONED CHANGE OF THE SURGICAL PROCEDURE, THE RISK FOR SERIOUS DETERIORATION IN STATE OF HEALTH IS NOT NEGLIGIBLE. THUS, A REPORT IS REQUIRED.

Additional Manufacturer Narrative

CORRECTION WAS MADE IN SECTION B1 TO REFLECT THAT THIS IS A SERIOUS INJURY AND NOT A MALFUNCTION AS THE INITIAL REPORT STATED. AS THE DEVICE IN QUESTION WAS NOT RETURNED BY THE CUSTOMER, AN INVESTIGATION ON THE PRODUCT ITSELF COULD NOT BE PERFORMED. HOWEVER, THE AVAILABLE INFORMATION HAS BEEN REVIEWED. THE INVESTIGATION WAS COMPLETED ON 2024-04-15. THE EVALUATION BASED ON THE PROVIDED INFORMATION REVEALED THE FOLLOWING: THE CUSTOMER DESCRIBES THAT WITHIN MINUTES THE IMAGE WAS DISTORTED WHEN GOING CLOSE TO TISSUE. AFTER INTERNAL DISCUSSIONS WITH A SME, THE DESCRIBED DISTORION IS MOST LIKELY A NORMAL BEHAVIOUR OF THE ENDOSCOPE WHEN IT IS BROUGHT TO CLOSE TO AN OBJECT. IT GETS OUT OF FOCUS AND THE PICTURE GETS DISTORTED TO A CERTAIN DEGREE. FURTHERMORE, THE DEVICE HISTORY RECORDS HAVE BEEN CHECKED FOR THE AVAILABLE LOT NUMBER AND FOUND TO BE ACCORDING TO THE SPECIFICATION, VALID AT THE TIME OF PRODUCTION. NO FURTHER COMPLAINTS REGISTERED AGAINST THE SAME LOT NOR THE ARTICLE NUMBER. THERE IS NO INDICATION FOR A MANUFACTURING OR DESIGN RELATED ERROR. BASED ON THE PROVIDED INFORMATION AND WITHOUT A DEVICE FOR INVESTIGATION, A PRODUCT PROBLEM IS EXCLUDED. THE EVENT IS FILED UNDER INTERNAL KARL STORZ COMPLAINT ID: (B)(4).