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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: AIZU OLYMPUS CO., LTD. RHINO-LARYNGOFIBERSCOPE

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AIZU OLYMPUS CO., LTD. RHINO-LARYNGOFIBERSCOPE Back to Search Results
Model Number ENF-XP
Medical Device Problem Code Corroded (1131)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 03/21/2025
Type of Reportable Event Malfunction
Event or Problem Description
It was observed that during the device evaluation, the rhino-laryngofiberscope exhibited corrosion inside the lens or the light guide prong.There was no patient involvement.
 
Additional Manufacturer Narrative
The device was returned to olympus for inspection.A root cause could not be identified.Based on the results of the investigation, it is likely the following led to the malfunction: a degradation problem was identified.The most probable cause is traced to component failure.Should additional relevant information become available, a supplemental report will be submitted.Olympus will continue to monitor field performance for this device.
 
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Brand Name
RHINO-LARYNGOFIBERSCOPE
Common Device Name
RHINO-LARYNGOFIBERSCOPE
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 965-8 520
JA   965-8520
Manufacturer Contact
todd brill
800 west park drive
westborough, MA 01581
5082077661
MDR Report Key23839408
Report Number9610595-2025-40627
Device Sequence Number13215732
Product Code EOB
UDI-Device Identifier04953170059018
UDI-Public04953170059018
Combination Product (Y/N)N
Initial Reporter StateNY
Initial Reporter CountryUS
PMA/510(K) Number
K221660
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)N
Reporter Type Manufacturer
Report Source Company Representative
Initial Reporter Occupation Non-Healthcare Professional
Type of Report Initial
Report Date (Section B) 12/18/2025
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 Other
Device Model NumberENF-XP
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer03/24/2025
Type of Report(Section G)Initial
Initial Date Received by Manufacturer 11/27/2025
Initial Report FDA Received Date12/18/2025
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured02/07/2022
Is the Device Labeled for Single Use? (Y/N) No
Is This a Single-Use Device that was
Reprocessed and Reused on a Patient? (Y/N)
No
Usage of Device Reuse
Patient Sequence Number1
Patient SexUnknown
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