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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: HOYA CORPORATION PENTAX TOKYO OFFICE PENTAX MEDICAL; EB19-J10U ULTRASOUND VIDEO BRONCHOSCOPE (US)

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HOYA CORPORATION PENTAX TOKYO OFFICE PENTAX MEDICAL; EB19-J10U ULTRASOUND VIDEO BRONCHOSCOPE (US) Back to Search Results
Model Number EB19-J10U
Medical Device Problem Code Optical Obstruction (3002)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 01/15/2026
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
The product was returned to pentax medical for repair.Our technician checked the returned unit and confirmed that the objective lens cloudy (not clear view).Based on the result, we concluded that it was caused due to the moisture condensation in the objective lens.In addition, our technician confirmed that the insertion flexible tube fluid damage, the segment fluid damage, the control body fluid damage, the us connector cable (long) buckled, the control body corroded, the angle lever trim cap missing, the insertion flexible tube crushed, the operation channel (primary) leak, the bending rubber leak, the operation channel (primary) cut, the bending rubber cut, and the operation channel (primary) kink; however, these defects are not the main cause, and/or irrelevant to the alleged complaint.Based on the technical report ""hr-rpt-0586(image failure)"" and/or the risk analysis results, it was evaluated to submit mdr.
 
Event or Problem Description
The time of event is unknown.There was no report of patient harm.Video image failure(cloudy ).
 
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Brand Name
PENTAX MEDICAL
Common Device Name
EB19-J10U ULTRASOUND VIDEO BRONCHOSCOPE (US)
Manufacturer (Section D)
HOYA CORPORATION PENTAX TOKYO OFFICE
tsutsujigaoka 1-1-110
akishima-shi, tokyo 196-0 012
JA  196-0012
Manufacturer (Section G)
HOYA CORPORATION PENTAX TOKYO OFFICE
tsutsujigaoka 1-1-110
akishima-shi, tokyo 196-0 012
JA   196-0012
Manufacturer Contact
paresh patel
3 paragon drive
montvale, NJ 07645
8004315880
MDR Report Key24275342
Report Number9610877-2026-50300
Device Sequence Number9803186
Product Code EOQ
UDI-Device Identifier04961333222162
UDI-Public(01)04961333222162(11)230901
Combination Product (Y/N)N
Initial Reporter StateNJ
Initial Reporter CountryUS
PMA/510(K) Number
K183516
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)Unknown
Reporter Type Manufacturer
Report Source Health Professional
Initial Reporter Occupation Physician
Type of Report Initial
Report Date (Section B) 02/06/2026
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 NumberEB19-J10U
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer01/15/2026
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 01/15/2026
Initial Report FDA Received Date02/06/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured09/01/2023
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
Patient Sequence Number1
Patient SexUnknown
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