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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 "PLASMALOOP", LOOP, LARGE, 24 FR., 12°-30°, ESG TCRIS; ENDOSCOPIC ELECTROSURGICAL ELECTRODE, BIPOLAR, SINGLE-USE

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OLYMPUS MEDICAL PRODUCTS CZECH, SPOL. S R.O. HF-RESECTION ELECTRODE "PLASMALOOP", LOOP, LARGE, 24 FR., 12°-30°, ESG TCRIS; ENDOSCOPIC ELECTROSURGICAL ELECTRODE, BIPOLAR, SINGLE-USE Back to Search Results
Model Number WA47707S
Medical Device Problem Code Break (1069)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 02/25/2026
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 resection electrode bipolar loop broke.The issue was found during a bipolar transurethral resection of the prostate, therapeutic procedure.There were no reports of patient injury or harm.
 
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Brand Name
HF-RESECTION ELECTRODE "PLASMALOOP", LOOP, LARGE, 24 FR., 12°-30°, ESG TCRIS
Common Device Name
ENDOSCOPIC ELECTROSURGICAL ELECTRODE, BIPOLAR, SINGLE-USE
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 Key25153172
Report Number3007960282-2026-00100
Device Sequence Number9351948
Product Code FAS
UDI-Device Identifier14042761085547
UDI-Public14042761085547
Combination Product (Y/N)N
Initial Reporter CountryBR
PMA/510(K) Number
K171965
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 Other
Type of Report Initial,Followup
Report Date (Section B) 06/17/2026
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 NumberWA47707S
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? No
Type of Report(Section G)Follow-Up
Initial Date Received by Manufacturer 04/28/2026
Supplement Date Received by Manufacturer06/15/2026
Initial Report FDA Received Date05/12/2026
Supplement Report FDA Received Date06/17/2026
Was Device Evaluated by Manufacturer? (Y/N) No
Date Device Manufactured02/11/2025
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)
Yes
Usage of Device Initial
Patient Sequence Number1
Patient SexUnknown
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