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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: OLYMPUS MEDICAL PRODUCTS CZECH, SPOL. S R.O. HF-RESECTION ELECTRODE "PLASMALOOP", LOOP, LARGE, 24 FR., 12°-30°, ESG TCRIS; WA47707S

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OLYMPUS MEDICAL PRODUCTS CZECH, SPOL. S R.O. HF-RESECTION ELECTRODE "PLASMALOOP", LOOP, LARGE, 24 FR., 12°-30°, ESG TCRIS; WA47707S Back to Search Results
Model Number WA47707S
Medical Device Problem Codes Break (1069); Melted (1385)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 11/19/2025
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
The investigation is ongoing.A supplemental report will be submitted when the investigation is completed or if additional information becomes available.
 
Event or Problem Description
It was reported the hf-resection electrode "plasmaloop" had the loop break.It appeared that part of it had melted.The malfunction occurred during a therapeutic transurethral resection procedure.There were no reports of patient harm.
 
Additional Manufacturer Narrative
B5: no additional information received from customer.H2: additional information, device evaluation h3: additional information h4: additional information h6: additional information this report is being supplemented to provide additional information based on the approved 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, and since the device was not returned for evaluation, the definitive root cause of the reported issue could not be determined.Olympus will continue to monitor field performance for this device.
 
Event or Problem Description
No additional information received from customer.
 
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Brand Name
HF-RESECTION ELECTRODE "PLASMALOOP", LOOP, LARGE, 24 FR., 12°-30°, ESG TCRIS
Common Device Name
WA47707S
Manufacturer (Section D)
OLYMPUS MEDICAL PRODUCTS CZECH, SPOL. S R.O.
telickova 457/29
prerov 75124
EZ  75124
Manufacturer (Section G)
OLYMPUS MEDICAL PRODUCTS CZECH, SPOL. S R.O.
telickova 457/29
prerov 75124
EZ   75124
Manufacturer Contact
todd brill
801 west park drive
westborough, MA 01581
5082077661
MDR Report Key23770101
Report Number3007960282-2025-00227
Device Sequence Number9723138
Product Code FAS
UDI-Device Identifier14042761085547
UDI-Public14042761085547
Combination Product (Y/N)N
Initial Reporter CountryBR
PMA/510(K) Number
K171965
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)N
Reporter Type Manufacturer
Report Source Foreign,User Facility,Distributor
Initial Reporter Occupation Other
Type of Report Initial,Followup
Report Date (Section B) 04/23/2026
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
Operator of Device Health Professional
Device Model NumberWA47707S
Device Lot Number1000161973
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? No
Type of Report(Section G)Initial
Initial Date Received by Manufacturer 11/19/2025
Supplement Date Received by Manufacturer03/30/2026
Initial Report FDA Received Date12/10/2025
Supplement Report FDA Received Date04/23/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured09/30/2024
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 Initial
Patient Sequence Number1
Patient SexUnknown
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