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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: HOYA CORPORATION PENTAX TOKYO OFFICE PENTAX; LINEAR ULTRASOUND VIDEO GASTROSCOPE

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HOYA CORPORATION PENTAX TOKYO OFFICE PENTAX; LINEAR ULTRASOUND VIDEO GASTROSCOPE Back to Search Results
Model Number EG-3270UK
Medical Device Problem Code Optical Obstruction (3002)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 06/01/2026
Type of Reportable Event Malfunction
Event or Problem Description
The time of event is unknown.There was no report of patient harm.Video image failure (cloudy).
 
Additional Manufacturer Narrative
The product was returned to pentax medical for repair.Our technician checked the returned unit and confirmed that the objective prism cloudy (not clear view).Based on the result, we concluded that it was caused due to the moisture condensation in the objective prism.In addition, our technician confirmed that the us connector cable (long) buckled, the ccd drive pcb corroded, the electrical pin connector corroded, the lg connector corroded, and the deflector washing socket deformed; however, these defects are not the main cause, and/or irrelevant to the alleged complaint.Based on the technical report "hr-rpt-0586 (image failure)" and/or the risk analysis results, it was evaluated to submit mdr.
 
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Brand Name
PENTAX
Common Device Name
LINEAR ULTRASOUND VIDEO GASTROSCOPE
Manufacturer (Section D)
HOYA CORPORATION PENTAX TOKYO OFFICE
tsutsujigaoka 1-1-110
akishima-shi, tokyo 196-0 012
JA  196-0012
Manufacturer (Section G)
HOYA CORPORATION PENTAX TOKYO OFFICE
tsutsujigaoka 1-1-110
akishima-shi, tokyo 196-0 012
JA   196-0012
Manufacturer Contact
paresh patel
3 paragon drive
montvale, NJ 07645
8004315880
MDR Report Key25542254
Report Number9610877-2026-51286
Device Sequence Number10448767
Product Code ODG
UDI-Device Identifier04961333213290
UDI-Public(01)04961333213290(11)190417
Combination Product (Y/N)N
Initial Reporter StateMN
Initial Reporter CountryUS
PMA/510(K) Number
K182004
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)Unknown
Reporter Type Manufacturer
Report Source Health Professional
Initial Reporter Occupation Physician
Type of Report Initial
Report Date (Section B) 06/18/2026
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 NumberEG-3270UK
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer06/01/2026
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 06/01/2026
Initial Report FDA Received Date06/18/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured04/17/2019
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
Patient Sequence Number1
Patient SexUnknown
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