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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: SHIRAKAWA OLYMPUS CO., LTD. RHINO-LARYNGO VIDEOSCOPE

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SHIRAKAWA OLYMPUS CO., LTD. RHINO-LARYNGO VIDEOSCOPE Back to Search Results
Model Number ENF-VH
Medical Device Problem Code Peeled/Delaminated (1454)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 07/16/2026
Type of Reportable Event Malfunction
Event or Problem Description
The customer returned the rhino-laryngo videoscope to the service center for a separate issue.During the device analysis, the service repair technician indicates that a reportable malfunction was found.It was determined that the adhesive on the bending section cover glue peeled off at the distal end.There was no patient involvement.
 
Additional Manufacturer Narrative
The device was returned to olympus for inspection.Based on the results of the investigation, the most probable cause of this complaint is expected or random component failure without any design or manufacturing issue.Should additional relevant information become available, a supplemental report will be submitted.Olympus will continue to monitor field performance for this device.
 
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Brand Name
RHINO-LARYNGO VIDEOSCOPE
Common Device Name
RHINO-LARYNGO VIDEOSCOPE
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
+1(508)207-7661
MDR Report Key50267732
Report Number3002808148-2026-28460
Device Sequence Number18721262
Product Code EOB
UDI-Device Identifier04953170411403
UDI-Public04953170411403
Combination Product (Y/N)N
Initial Reporter StateFL
Initial Reporter CountryUS
PMA/510(K) Number
K221638
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) 08/14/2026
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 Other
Device Model NumberENF-VH
Was Device Available for Evaluation? Yes
Date Returned to Manufacturer07/27/2026
Is the Reporter a Health Professional? No
Initial Date Received by Manufacturer 07/23/2026
Initial Report FDA Received Date08/16/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
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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