• Decrease font size
  • Return font size to normal
  • Increase font size
U.S. Department of Health and Human Services

MAUDE Adverse Event Report: AIZU OLYMPUS CO., LTD. EVIS EXERA III BRONCHOFIBERVIDEOSCOPE

  • Print
  • Share
  • E-mail
-
Super Search Devices@FDA
510(k) | DeNovo | Registration & Listing | Adverse Events | Recalls | PMA | HDE | Classification | Standards
CFR Title 21 | Radiation-Emitting Products | X-Ray Assembler | Medsun Reports | CLIA | TPLC
 

AIZU OLYMPUS CO., LTD. EVIS EXERA III BRONCHOFIBERVIDEOSCOPE Back to Search Results
Model Number BF-MP190F
Medical Device Problem Code Contamination /Decontamination Problem (2895)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
The device was evaluated.Device evaluation found the device forceps passage had a stuck brush.Cleaning brush passage test failed.Based on investigation results, the reported issue was confirmed.The root cause of the brush stuck in forceps passage inside the channel cannot be conclusively identified.Probable cause based on reasonably known information based on device evaluation was due to blockage caused by kinks/crimped found in the insertion tube of the device.Olympus will continue to monitor field performance for this device.
 
Event or Problem Description
It was observed during the device evaluation, the bronchofibervideoscope exhibited stuck foreign material inside channel.There was no patient involvement.
 
Search Alerts/Recalls

  New Search  |  Submit an Adverse Event Report

Brand Name
EVIS EXERA III BRONCHOFIBERVIDEOSCOPE
Common Device Name
BRONCHOFIBERVIDEOSCOPE
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 Key24394195
Report Number9610595-2026-16195
Device Sequence Number8365771
Product Code EOQ
UDI-Device Identifier04953170395581
UDI-Public04953170395581
Combination Product (Y/N)N
Initial Reporter CountryUS
PMA/510(K) Number
K172726
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) 02/19/2026
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-MP190F
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer11/13/2025
Type of Report(Section G)Initial
Initial Date Received by Manufacturer 02/14/2026
Initial Report FDA Received Date02/19/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured12/01/2023
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
Usage of Device Reuse
Patient Sequence Number1
Patient SexUnknown
-
-