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U.S. Department of Health and Human Services

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

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AIZU OLYMPUS CO., LTD. EVIS EXERA BRONCHOFIBERVIDEOSCOPE Back to Search Results
Model Number BF-MP160F
Medical Device Problem Code Crack (1135)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 04/24/2025
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
The device was returned to olympus for inspection.A root cause was identified.Based on the results of the investigation, it is likely the following led to the malfunction: component failure, stress problem identified.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
The bronchovideoscope was returned to the service center with a report of image with scratch. this does not indicate an mdr reportable event. however, mdr reportable failure was found during testing at the service center.During inspection of the device, chipped objective lens was found.There was no patient involvement.
 
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Brand Name
EVIS EXERA 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 Key24872920
Report Number9610595-2026-30414
Device Sequence Number10084348
Product Code EOQ
UDI-Device Identifier04953170289064
UDI-Public04953170289064
Combination Product (Y/N)N
Initial Reporter CountryBR
PMA/510(K) Number
K033225
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)N
Reporter Type Manufacturer
Report Source Foreign,Company Representative
Initial Reporter Occupation Non-Healthcare Professional
Type of Report Initial
Report Date (Section B) 04/14/2026
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-MP160F
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer05/20/2025
Type of Report(Section G)Initial
Initial Date Received by Manufacturer 03/27/2026
Initial Report FDA Received Date04/14/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured02/19/2008
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
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