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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: AIZU OLYMPUS CO., LTD. FIBERSCOPE "HYF-XP"; HYSTEROFIBERSCOPE

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AIZU OLYMPUS CO., LTD. FIBERSCOPE "HYF-XP"; HYSTEROFIBERSCOPE Back to Search Results
Model Number HYF-XP
Device Problem Microbial Contamination of Device (2303)
Patient Problem No Clinical Signs, Symptoms or Conditions (4582)
Event Date 01/09/2024
Event Type  malfunction  
Manufacturer Narrative
The suspect device has been returned to olympus for evaluation and the investigation is ongoing.The physical device evaluation has not been completed.Prior to the device evaluation, the device was sent out for additional microbiological testing.The microbiological analysis results are pending.The customer provided the cleaning sterilization and disinfection (cds) processes performed at the user facility.The detergent used was anios¿clean excel d.The instrument/suction channel, suction cylinder, instrument channel port and distal end were brushed.The disinfectant used was anios¿clean excel d.The device was stored in horizontal storage.Additionally, the customer confirmed that there were no suspected patient infections due to the facility findings.Once the investigation has been completed, a supplemental report will be submitted with device evaluation results.
 
Event Description
It was reported that, during reprocessing, the hysterofiberscope tested positive for 1 colony forming units (cfu) of staphylococcus hominis on (b)(6) 2023.The device was tested positive again on (b)(6) 2024, for 5 colony forming units (cfus) of neisseria spp.All channels were sampled.The user did not report any contamination or any other serious deterioration in state of health of any person, to which the scope could have been a contributory cause.
 
Manufacturer Narrative
Correction to h10 of the first supplemental report.Olympus provided the following result of the culture test, performed at the third-party labs: sampling date: (b)(6) 2024.Sampling from: all channels.Cfu: <1cfu.Bacterial identification: n/a.
 
Manufacturer Narrative
This report is being supplemented to provide additional information based on the legal manufacture's (lm) review of the customer completed cleaning disinfection and sterilization (cds) checklist, results of third-party testing, the device evaluation and the lms final investigation.The lm reviewed the customer provided the cds processes where no obvious deviations from instructions for use (ifu) were identified.Olympus provided the following result of the culture test, performed at the third-party labs: sampling date: feb 06, 2024 sampling from: all channels cfu: >1cfu bacterial identification: n/a the device was evaluated where no abnormalities were found that could have led to the positive culture.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, a root cause could not be determined.Growth of microorganisms were found through culture testing by the user after reprocessing.However, when olympus culture tested after reprocessing in accordance with the ifu before repair, the results conformed to the regulation's recommendation.The instruction manual of the subject device describes the reprocessing methods in the following chapters: chapter "compatible reprocessing methods and chemical agents" chapter "cleaning, disinfection, and sterilization procedures" olympus will continue to monitor field performance for this device.
 
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Brand Name
FIBERSCOPE "HYF-XP"
Type of Device
HYSTEROFIBERSCOPE
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 Key18637347
MDR Text Key334502509
Report Number9610595-2024-02381
Device Sequence Number1
Product Code HIH
Combination Product (y/n)N
Reporter Country CodeFR
PMA/PMN Number
K891451
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Other,Foreign,Health Professional,User Facility
Reporter Occupation Other
Type of Report Initial,Followup,Followup
Report Date 03/19/2024
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
Device Operator Health Professional
Device Model NumberHYF-XP
Was Device Available for Evaluation? Device Returned to Manufacturer
Is the Reporter a Health Professional? No
Was the Report Sent to FDA? No
Initial Date Manufacturer Received 01/18/2024
Initial Date FDA Received02/03/2024
Supplement Dates Manufacturer Received03/19/2024
03/19/2024
Supplement Dates FDA Received03/19/2024
03/19/2024
Was Device Evaluated by Manufacturer? Yes
Date Device Manufactured05/02/2007
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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