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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: OLYMPUS MEDICAL PRODUCTS CZECH, SPOL. S R.O. HF-RESECTION ELECTRODE, LOOP, 24 FR., 0.2 WIRE, MEDIUM, 30°

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OLYMPUS MEDICAL PRODUCTS CZECH, SPOL. S R.O. HF-RESECTION ELECTRODE, LOOP, 24 FR., 0.2 WIRE, MEDIUM, 30° Back to Search Results
Model Number WA22306D
Medical Device Problem Code Break (1069)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 02/18/2026
Type of Reportable Event Malfunction
Event or Problem Description
It was reported the resection electrode loop portion of the loop electrode was damaged.The issue was found during a transurethral resection, therapeutic procedure.The intended procedure was completed with an olympus back-up device.There were no reports of patient injury or 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
B5: no additional information received from customer.H2: additional information, device evaluation h3: additional information h4: additional information h6: additional information the device was returned to olympus for inspection and the reported failure was confirmed.A root cause could not be identified.Based on the results of the investigation, it is likely the following led to the malfunction: component failure.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
HF-RESECTION ELECTRODE, LOOP, 24 FR., 0.2 WIRE, MEDIUM, 30°
Common Device Name
HF-RESECTION ELECTRODE
Manufacturer (Section D)
OLYMPUS MEDICAL PRODUCTS CZECH, SPOL. S R.O.
telickova 457/29
prerov 75124
EZ  75124
Manufacturer (Section G)
OLYMPUS MEDICAL PRODUCTS CZECH, SPOL. S R.O.
telickova 457/29
prerov 75124
EZ   75124
Manufacturer Contact
todd brill
801 west park drive
westborough, MA 01581
5082077661
MDR Report Key24583896
Report Number3007960282-2026-00045
Device Sequence Number10475118
Product Code FAS
UDI-Device Identifier14042761051689
UDI-Public14042761051689
Combination Product (Y/N)N
Initial Reporter CountryJA
PMA/510(K) Number
K100275
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)N
Reporter Type Manufacturer
Report Source Foreign,User Facility
Initial Reporter Occupation Non-Healthcare Professional
Type of Report Initial,Followup
Report Date (Section B) 04/17/2026
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 NumberWA22306D
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer03/04/2026
Type of Report(Section G)Follow-Up
Initial Date Received by Manufacturer 02/20/2026
Supplement Date Received by Manufacturer03/23/2026
Initial Report FDA Received Date03/12/2026
Supplement Report FDA Received Date04/17/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured04/02/2025
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)
Yes
Usage of Device Initial
Patient Sequence Number1
Patient SexUnknown
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