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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: SHIRAKAWA OLYMPUS CO., LTD. HIGH DEFINITION LCD MONITOR; Endoscopic Video Imaging System/Component, Gastroenterology-Urology

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SHIRAKAWA OLYMPUS CO., LTD. HIGH DEFINITION LCD MONITOR; Endoscopic Video Imaging System/Component, Gastroenterology-Urology Back to Search Results
Model Number OEV262H
Medical Device Problem Code Erratic or Intermittent Display (1182)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 06/19/2026
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
The device was returned to olympus for inspection and the reported failure was not confirmed.A definitive root cause could not be identified.Based on the results of the investigation, the most probable cause of the complaint was not established.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 customer reported intermittent display errors, with the display cutting out during inspection for use involving an olympus high definition liquid crystal display monitor.There was no patient harm reported.
 
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Brand Name
HIGH DEFINITION LCD MONITOR
Common Device Name
Endoscopic Video Imaging System/Component, Gastroenterology-Urology
Manufacturer (Section D)
SHIRAKAWA OLYMPUS CO., LTD.
3-1 okamiyama
odakura, nishigo-mura,
nishishirakawa-gun, fukushima 961-8 061
JA  961-8061
Manufacturer (Section G)
SHIRAKAWA OLYMPUS CO., LTD.
3-1 okamiyama
odakura, nishigo-mura,
nishishirakawa-gun, fukushima 961-8 061
JA   961-8061
Manufacturer Contact
todd brill
800 west park drive
westborough, MA 01581
5082077661
MDR Report Key25813776
Report Number3002808148-2026-23845
Device Sequence Number16102609
Product Code FET
UDI-Device Identifier04953170363498
UDI-Public04953170363498
Combination Product (Y/N)N
Initial Reporter StateOK
Initial Reporter CountryUS
PMA/510(K) Number
K102379
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)N
Reporter Type Manufacturer
Report Source Health Professional,User Facility
Initial Reporter Occupation Biomedical Engineer
Type of Report Initial,Followup
Report Date (Section B) 08/04/2026
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 NumberOEV262H
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? No
Was the Report Sent to FDA? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 06/23/2026
Supplement Date Received by Manufacturer07/14/2026
Initial Report FDA Received Date07/14/2026
Supplement Report FDA Received Date08/04/2026
Was Device Evaluated by Manufacturer? (Y/N) No
Date Device Manufactured11/24/2016
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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