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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: SHIRAKAWA OLYMPUS CO., LTD. SDI CABLE 2.5M

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SHIRAKAWA OLYMPUS CO., LTD. SDI CABLE 2.5M Back to Search Results
Model Number MAJ-1951
Medical Device Problem Codes Erratic or Intermittent Display (1182); Unexpected Shutdown (4019)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that the serial digital interface cable had caused intermittent image disappearing, monitor shut-off and telecon problems.The issue was found during inspection for use.There were no reports of patient harm.
 
Additional Manufacturer Narrative
The investigation is ongoing.A supplemental report will be submitted when the investigation is completed or if additional information becomes available.
 
Additional Manufacturer Narrative
This supplemental report is being submitted to provide the results of the final investigation.Updated fields: d8, h2, h6, h11.The device was not returned to olympus for inspection, and therefore reported failure was not confirmed.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.Reasonably known information suggests probable causes such as material problems: degradation.Thermal problems: overheating.Mechanical problems: stress, deformation, wear, corrosion.Electrical problems: open circuits, short circuits, signal loss, component issues.These causes can occur between components such as boards, cables, sockets, pins, power supplies, displays, connectors, light sources, etc.Without any design or manufacturing issue.Should additional relevant information become available, a supplemental report will be submitted.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
SDI CABLE 2.5M
Common Device Name
SDI CABLE
Manufacturer (Section D)
SHIRAKAWA OLYMPUS CO., LTD.
3-1 okamiyama
odakura, nishigo-mura,
nishishirakawa-gun, fukushima 961-8 061
JA  961-8061
Manufacturer (Section G)
SHIRAKAWA OLYMPUS CO., LTD.
3-1 okamiyama
odakura, nishigo-mura,
nishishirakawa-gun, fukushima 961-8 061
JA   961-8061
Manufacturer Contact
todd brill
800 west park drive
westborough, MA 01581
5082077661
MDR Report Key24137157
Report Number3002808148-2026-02005
Device Sequence Number14810179
Product Code NWB
UDI-Device Identifier04953170305047
UDI-Public04953170305047
Combination Product (Y/N)N
Initial Reporter CountryIN
PMA/510(K) Number
K202646
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)N
Reporter Type Manufacturer
Report Source Foreign,Health Professional,User Facility
Initial Reporter Occupation Biomedical Engineer
Type of Report Initial,Followup
Report Date (Section B) 05/16/2026
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 NumberMAJ-1951
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Initial
Initial Date Received by Manufacturer 12/23/2025
Supplement Date Received by Manufacturer05/13/2026
Initial Report FDA Received Date01/21/2026
Supplement Report FDA Received Date05/16/2026
Was Device Evaluated by Manufacturer? (Y/N) No
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 Unknown
Patient Sequence Number1
Patient SexUnknown
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