MAUDE Adverse Event Report: HUNAN VATHIN MEDICAL INSTRUMENT CO., LTD. SINGLE-USE FLEXIBLE RHINOLARYNGOSCOPE

Model Number	RL-E1801
Medical Device Problem Code	Detachment of Device or Device Component (2907)
Health Effect - Clinical Code	Foreign Body In Patient (2687)
Date of Event	03/12/2024
Type of Reportable Event	Malfunction
Additional Manufacturer Narrative
A comprehensive review of the relevant production records, inspection reports, and test data for critical raw materials was conducted.No abnormalities were identified, thereby allowing us to reasonably exclude defects related to raw materials, components, or manufacturing processes.However, the possibility of an infrequent or isolated issue related to inadequate connectivity, potentially resulting in insufficient structural integrity, cannot be completely ruled out.Although the procedure was performed at the bedside in accordance with standard operating protocols, the potential for improper handling, such as excessive force or suboptimal angulation during operation, cannot be entirely excluded as a contributing factor to the breakage of the endoscope tip.The assessment of the product user manual (ifu) indicates that it has been stated in the manual: "the endoscope is intended for use in a hospital environment.It is designed for use in adults.".Due to the lack of detailed information, we were unable to confirm the dimensions of the catheter that might be used together.If the internal diameter of the catheter was insufficient, it may cause the endoscope to become lodged within the catheter, leading to the tip's fracture during removal or repositioning.Proposed actions may include: enhancing the clarity and visibility of instructions related to compatible accessories in the ifu; strengthening training programs for our sales personnel to reinforce awareness of critical usage precautions; and ensuring that end users, including hospitals and clinical staff, are appropriately informed and trained.Additionally, we will consider explicitly indicating the minimum required internal diameter for compatible catheters to minimize the risk of similar incidents.
Event or Problem Description
During a bedside procedure, the tip of a disposable flexible endoscope had broken off, which caused it to be lodged inside of tracheostomy tube.

• Brand Name: SINGLE-USE FLEXIBLE RHINOLARYNGOSCOPE
• Common Device Name: SINGLE-USE FLEXIBLE RHINOLARYNGOSCOPE
• Manufacturer (Section D): HUNAN VATHIN MEDICAL INSTRUMENT CO., LTD.; CH
• Manufacturer (Section G): HUNAN VATHIN MEDICAL INSTRUMENT CO., LTD.
• Manufacturer Contact: lily fei ; CH
• MDR Report Key: 22492760
• Report Number: 3016045249-2025-00001
• Device Sequence Number: 4234803
• Product Code: EOB
• UDI-Device Identifier: 06972197480467
• UDI-Public: (01)06972197480467
• Combination Product (Y/N): N
• PMA/510(K) Number: K230536
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Serviced by Third Party (Y/N): N
• Reporter Type: Manufacturer
• Report Source: Other
• Initial Reporter Occupation: Other
• Type of Report: Initial
• Report Date (Section B): 07/14/2025

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?: No
• Operator of Device: Health Professional
• Device Model Number: RL-E1801
• Device Lot Number: T2402006
• Was Device Available for Evaluation?: No
• Type of Report(Section G): Thirty-Day
• Initial Date Received by Manufacturer: Not provided
• Initial Report FDA Received Date: 07/14/2025
• Was Device Evaluated by Manufacturer? (Y/N): No
• Is the Device Labeled for Single Use? (Y/N): Yes
• Is This a Single-Use Device that was Reprocessed and Reused on a Patient? (Y/N): No
• Usage of Device: Unknown
• Patient Sequence Number: 1
• Outcome Attributed to Adverse Event: Other
• Patient Sex: Unknown