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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: AIZU OLYMPUS CO., LTD. ENDOEYE FLEX 3D DEFLECTABLE VIDEOSCOPE

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AIZU OLYMPUS CO., LTD. ENDOEYE FLEX 3D DEFLECTABLE VIDEOSCOPE Back to Search Results
Model Number LTF-190-10-3D
Device Problems Degraded (1153); Component Missing (2306)
Patient Problem No Clinical Signs, Symptoms or Conditions (4582)
Event Date 01/14/2024
Event Type  malfunction  
Event Description
It was observed that during the device evaluation, the deflectable videoscope had deterioration of the objective lenses and gluing of the insertion part with missing parts.The issue was found during reprocessing.There were no reports of patient involvement.
 
Manufacturer Narrative
The device was returned to olympus for evaluation and the evaluation found the following: there was a continuous flow of bubbles from the distal end and the master plug unit and master plug unit slave were cracked.The investigation is ongoing.A supplemental report will be submitted upon completion of the investigation or if any additional information is provided by the user facility.
 
Manufacturer Narrative
This report is being supplemented to provide additional information based on the legal manufacturer's final investigation.A review of the device history record found no deviations that could have caused or contributed to the reported issue.Based on the results of the investigation, there is a possibility that the event occurred due to physical stress caused by hitting the tip of the scope or dropping the tip, or chemical stress due to the chemical solution used, but it could not be identified.The event can be detected/prevented by following the instructions for use which state: "ltf-190-10-3d operation manual important information ¿ please read before use: contraindications, warnings, and precautions: do not strike, hit, or drop the endoscope¿s distal end, rigid portion, bending section, control section, universal cord, video connectors, or light guide connector.Also, do not bend, pull, or twist the endoscope¿s distal end, rigid portion, bending section, control section, universal cord, video connectors, or light guide connector with excessive force.The endoscope may be damaged and could cause patient injury, burns, bleeding, and/or perforations.It could also cause parts of the endoscope to fall off inside the patient.Ltf-190-10-3d reprocessing manual 3.1 compatibility summary: methods listed as ¿compatible¿ in table 3.1 and 3.2 are compatible for routine use only when used according to manufacturer¿s instructions.Repeated use and reprocessing of endoscopes and accessories lead to gradual wear and tear.Furthermore, reprocessing methods that employ higher temperatures and more caustic/corrosive materials may lead to faster deterioration.In general, sterilization processes are harsher on equipment than disinfection processes.Before each patient procedure, inspect the endoscope and accessories for damage, according to the instructions described in this manual and its companion ¿operation manual¿.Reprocessing manual: 3.1 compatibility summary: list of compatible methods validated in terms of material durability: sterrad® 50/100s/200/nx¿: sterilization by sterrad® 50/100s/200/nx¿ system may deteriorate the adhesive of the insertion section.Depending on the circumstances, replacement of the insertion section may be required.Before use, confirm that the endoscope is free from any damage or other irregularities.For further details, contact olympus".Olympus will continue to monitor field performance for this device.
 
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Brand Name
ENDOEYE FLEX 3D DEFLECTABLE VIDEOSCOPE
Type of Device
FLEX 3D DEFLECTABLE VIDEOSCOPE
Manufacturer (Section D)
AIZU OLYMPUS CO., LTD.
3-1-1 niiderakita
aizuwakamatsu-shi, fukushima 965-8 520
JA  965-8520
Manufacturer (Section G)
AIZU OLYMPUS CO., LTD.
3-1-1 niiderakita
aizuwakamatsu-shi, fukushima
Manufacturer Contact
todd brill
800 west park drive
westborough, MA 01581
5082077661
MDR Report Key18580516
MDR Text Key333822912
Report Number9610595-2024-01614
Device Sequence Number1
Product Code GCJ
UDI-Device Identifier04953170434938
UDI-Public04953170434938
Combination Product (y/n)N
Reporter Country CodeFI
PMA/PMN Number
K123365
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Other,Foreign,User Facility,Company Representative
Reporter Occupation Other
Type of Report Initial,Followup
Report Date 02/16/2024
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received01/25/2024
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Operator Health Professional
Device Model NumberLTF-190-10-3D
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer01/17/2024
Is the Reporter a Health Professional? No
Was the Report Sent to FDA? No
Date Manufacturer Received02/08/2024
Was Device Evaluated by Manufacturer? Yes
Date Device Manufactured01/29/2018
Is the Device Single Use? No
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Reuse
Patient Sequence Number1
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