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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: AIZU OLYMPUS CO., LTD. ENDOSCOPE REPROCESSOR

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AIZU OLYMPUS CO., LTD. ENDOSCOPE REPROCESSOR Back to Search Results
Model Number OER-ELITE
Medical Device Problem Code Filling Problem (1233)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 04/13/2026
Type of Reportable Event Malfunction
Event or Problem Description
The gastrointestinal videoscope was inspected at customer site for a separate issue.During the device analysis, a reportable event was found.It was determined as part of the completed investigation that 50 pounds per square inch was considered low incoming water flow.There was no patient involvement.
 
Additional Manufacturer Narrative
The fse performed an internal water filter air purge, clearing the trapped air and restoring normal water flow to resolve the issue.A definitive root cause could not be identified.Based on the results of the investigation, the most probable cause was component failure.Should additional relevant information become available, a supplemental report will be submitted.Olympus will continue to monitor the field performance for this device.
 
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Brand Name
ENDOSCOPE REPROCESSOR
Common Device Name
ENDOSCOPE REPROCESSOR
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 Key25351817
Report Number9610595-2026-44691
Device Sequence Number10750885
Product Code FEB
UDI-Device Identifier04953170404047
UDI-Public04953170404047
Combination Product (Y/N)N
Initial Reporter StateWA
Initial Reporter CountryUS
PMA/510(K) Number
K201920
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) 06/01/2026
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 NumberOER-ELITE
Was Device Available for Evaluation? Yes
Type of Report(Section G)Initial
Initial Date Received by Manufacturer 05/27/2026
Initial Report FDA Received Date06/01/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured09/20/2024
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 Unknown
Patient Sequence Number1
Patient SexUnknown
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