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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: AIZU OLYMPUS CO., LTD. EVIS EXERA II BRONCHOVIDEOSCOPE

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AIZU OLYMPUS CO., LTD. EVIS EXERA II BRONCHOVIDEOSCOPE Back to Search Results
Model Number BF-P180
Medical Device Problem Code No Display/Image (1183)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 10/20/2025
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
The device was evaluated.As noted in section b5, inspection found the device had no image.Based on the results of the investigation, the image issue was attributed to electronic component failure.Reasonably known information suggests probable causes such as damage or deterioration of parts, environment problem like as dust/dirt/humidity, optical problem, overheating problem, and electrical problems like as signal loss or open circuit.The most probable cause of this complaint is expected or random component failure without any design or manufacturing issue.Olympus will continue to monitor field performance for this device.
 
Event or Problem Description
It was observed during the device evaluation, the bronchovideoscope displayed no image.There was no patient involvement.
 
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Brand Name
EVIS EXERA II BRONCHOVIDEOSCOPE
Common Device Name
BRONCHOVIDEOSCOPE
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 Key24134960
Report Number9610595-2026-07036
Device Sequence Number14804293
Product Code EOQ
UDI-Device Identifier04953170339288
UDI-Public04953170339288
Combination Product (Y/N)N
Initial Reporter CountryUS
PMA/510(K) Number
K061313
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) 01/21/2026
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 Other
Device Model NumberBF-P180
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer10/22/2025
Type of Report(Section G)Initial
Initial Date Received by Manufacturer 12/30/2025
Initial Report FDA Received Date01/21/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured08/01/2011
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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