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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: AOMORI OLYMPUS CO., LTD. THUNDERBEAT 5 MM, 35 CM, FRONT-ACTUATED GRIP TYPE S; ULTRASONIC SURGICAL DEVICE

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AOMORI OLYMPUS CO., LTD. THUNDERBEAT 5 MM, 35 CM, FRONT-ACTUATED GRIP TYPE S; ULTRASONIC SURGICAL DEVICE Back to Search Results
Model Number TB-0535FCS
Medical Device Problem Code Fracture (1260)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 02/11/2026
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
The investigation is ongoing.A supplemental report will be submitted when the investigation is completed or if additional information becomes available.
 
Event or Problem Description
It was reported the thunderbeat tip broke.The issue occurred during an unspecified therapeutic procedure.There were no reports of patient harm.
 
Event or Problem Description
Update from the customer: the issue occurred during a cholecystectomy procedure.The procedure was successfully completed.
 
Additional Manufacturer Narrative
This supplemental report is being submitted to provide the results of the final investigation.Updated fields: b5, d9, h2, h3, h6.The device was not returned to olympus for inspection and the reported failure was not confirmed.A root cause could not be identified.Based on the results of the investigation, it is likely the following led to the malfunction: no problem detected due to the device not being returned to olympus.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
THUNDERBEAT 5 MM, 35 CM, FRONT-ACTUATED GRIP TYPE S
Common Device Name
ULTRASONIC SURGICAL DEVICE
Manufacturer (Section D)
AOMORI OLYMPUS CO., LTD.
2-248-1 okkonoki
kuroishi-shi, aomori 036-0 357
JA  036-0357
Manufacturer (Section G)
AOMORI OLYMPUS CO., LTD.
2-248-1 okkonoki
kuroishi-shi, aomori 036-0 357
JA   036-0357
Manufacturer Contact
todd brill
800 west park drive
westborough, MA 01581
5082077661
MDR Report Key24394417
Report Number9614641-2026-00213
Device Sequence Number8569711
Product Code GEI
UDI-Device Identifier04953170383557
UDI-Public04953170383557
Combination Product (Y/N)N
Initial Reporter CountryKS
PMA/510(K) Number
K211838
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)N
Reporter Type Manufacturer
Report Source User Facility,Company Representative
Initial Reporter Occupation Non-Healthcare Professional
Type of Report Initial,Followup,Followup
Report Date (Section B) 06/11/2026
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 Expiration Date03/31/2024
Device Model NumberTB-0535FCS
Device Lot Number14K28
Was Device Available for Evaluation? Device Returned to Manufacturer
Type of Report(Section G)Initial
Initial Date Received by Manufacturer 02/11/2026
Supplement Date Received by Manufacturer03/11/2026
05/18/2026
Initial Report FDA Received Date02/19/2026
Supplement Report FDA Received Date03/19/2026
06/11/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured04/28/2021
Is the Device Labeled for Single Use? (Y/N) Yes
Is This a Single-Use Device that was
Reprocessed and Reused on a Patient? (Y/N)
No
Usage of Device Initial
Patient Sequence Number1
Patient SexUnknown
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