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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: OLYMPUS WINTER & IBE GMBH HF-CABLE, BIPOLAR; ELECTRICAL-ONLY MEDICAL DEVICE CONNECTION CABLE, REUSABLE

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OLYMPUS WINTER & IBE GMBH HF-CABLE, BIPOLAR; ELECTRICAL-ONLY MEDICAL DEVICE CONNECTION CABLE, REUSABLE Back to Search Results
Model Number WA00014A
Medical Device Problem Codes Break (1069); Sparking (2595)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
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
The customer reported sparking at the bipolar cables, and the cable broke off during procedure involving an olympus electrical only medical device connection cable, reusable.There was no patient injury reported.
 
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Brand Name
HF-CABLE, BIPOLAR
Common Device Name
ELECTRICAL-ONLY MEDICAL DEVICE CONNECTION CABLE, REUSABLE
Manufacturer (Section D)
OLYMPUS WINTER & IBE GMBH
kuehnstrasse 61
hamburg, hamburg 22045
GM  22045
Manufacturer (Section G)
OLYMPUS WINTER & IBE GMBH
kuehnstrasse 61
hamburg, hamburg 22045
GM   22045
Manufacturer Contact
todd brill
800 west park drive
westborough, MA 01581
5082077661
MDR Report Key25359433
Report Number9610773-2026-04212
Device Sequence Number9808443
Product Code FAS
UDI-Device Identifier04042761076449
UDI-Public04042761076449
Combination Product (Y/N)N
Initial Reporter CountryUK
PMA/510(K) Number
K120418
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)N
Reporter Type Manufacturer
Report Source Foreign,Health Professional,User Facility
Initial Reporter Occupation Nurse
Type of Report Initial,Followup,Followup
Report Date (Section B) 06/25/2026
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 NumberWA00014A
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Follow-Up
Initial Date Received by Manufacturer 05/08/2026
Supplement Date Received by Manufacturer06/03/2026
06/24/2026
Initial Report FDA Received Date06/02/2026
Supplement Report FDA Received Date06/03/2026
06/25/2026
Was Device Evaluated by Manufacturer? (Y/N) No
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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