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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: AIZU OLYMPUS CO., LTD. ENDOSCOPE REPROCESSOR

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AIZU OLYMPUS CO., LTD. ENDOSCOPE REPROCESSOR Back to Search Results
Model Number OER-5
Device Problem Insufficient Information (3190)
Patient Problem Drug Resistant Bacterial Infection (4553)
Event Type  Injury  
Event Description
The customer reports there was an outbreak of extended spectrum beta-lactamase-resistant (esbl) bacteria at the hospital in patients who have undergone a procedure with a gastrointestinal videoscope (that had been reprocessed with an automatic scope reprocessor (aer)), per the physician in the infectious diseases department of the facility.The physician requested information regarding endoscope reprocessing methods and culture test methods in order to investigate the cause of the outbreak.It is unknown at this time if the outbreak is related to the scope.The field safety engineer (fse) staff has explained the culture method and reprocessing method to the facility.No scope culture results are available at this time.It is unknown how many patients are involved.It is unknown what treatment/intervention has been provided to the patients.The patients¿ current condition is unknown.This information has been requested and not yet provided.Case with patient identifier (b)(6) reports the scope case with patient identifier (b)(6) reports the automated scope reprocessor the scope has been reprocessed in.
 
Manufacturer Narrative
The device referenced in this report was not returned to olympus for evaluation.The definitive cause of the user's experience cannot be determined at this time.The investigation is ongoing.This report will be updated upon completion of the investigation or upon receipt of additional relevant information.
 
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.It has been over 2 years since the subject device was manufactured.Based on the results of the investigation, a relationship between the subject device and the infection could not be determined as detailed information could not be obtained from the user.Therefore, the root cause of the event could not be identified.The event can be detected/prevented by following the instructions for use (ifu): operation manual: thoroughly review and understand the instruction manual before use to prevent infections.This supplemental report includes a correction to g2 to provide information that was inadvertently not included on the initial medwatch.Also, new information added to h4.Olympus will continue to monitor field performance for this device.
 
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Brand Name
ENDOSCOPE REPROCESSOR
Type of Device
ENDOSCOPE REPROCESSOR
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 Key15998827
MDR Text Key305677622
Report Number9610595-2022-05603
Device Sequence Number1
Product Code FEB
Combination Product (y/n)N
Reporter Country CodeJA
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Foreign,Health Professional,User Facility,Company Representative
Reporter Occupation Physician
Type of Report Initial,Followup
Report Date 02/28/2023
1 Device was Involved in the Event
1 Patient was Involved in the Event
Is this an Adverse Event Report? Yes
Is this a Product Problem Report? Yes
Device Operator Health Professional
Device Model NumberOER-5
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Was the Report Sent to FDA? No
Initial Date Manufacturer Received 11/17/2022
Initial Date FDA Received12/16/2022
Supplement Dates Manufacturer Received02/17/2023
Supplement Dates FDA Received02/28/2023
Was Device Evaluated by Manufacturer? Device Not Returned to Manufacturer
Date Device Manufactured06/24/2020
Is the Device Single Use? No
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Reuse
Patient Sequence Number1
Treatment
GIF-XZ1200.
Patient Outcome(s) Other;
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