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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: AIZU OLYMPUS CO., LTD. ENDOEYE FLEX DEFLECTABLE VIDEOSCOPE

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AIZU OLYMPUS CO., LTD. ENDOEYE FLEX DEFLECTABLE VIDEOSCOPE Back to Search Results
Model Number LTF-S190-5
Medical Device Problem Code Optical Problem (3001)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 07/21/2026
Type of Reportable Event Malfunction
Event or Problem Description
The customer returned the flex deflectable videoscope for a separate issue.During the device analysis, the image was flickering when angulating the angulation lever.There was no patient involvement, and no harm was reported as a result of this event.
 
Additional Manufacturer Narrative
The device was not returned to olympus for inspection.Based on the results of the investigation, a definitive root cause of the image was flickering when angulating the angulation lever could not be determined.However, the issue was likely the result of a degradation problem, and/or external factors.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
ENDOEYE FLEX DEFLECTABLE VIDEOSCOPE
Common Device Name
FLEX DEFLECTABLE VIDEOSCOPE
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
+1(508)207-7661
MDR Report Key50663813
Report Number9610595-2026-73420
Device Sequence Number18526713
Product Code GCJ
UDI-Device Identifier04953170310355
UDI-Public04953170310355
Combination Product (Y/N)N
Initial Reporter CountryUS
PMA/510(K) Number
K201832
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)N
Reporter Type Manufacturer
Report Source Foreign,Company Representative
Initial Reporter Occupation Non-Healthcare Professional
Type of Report Initial
Report Date (Section B) 09/08/2026
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 NumberLTF-S190-5
Was Device Available for Evaluation? Yes
Is the Reporter a Health Professional? No
Initial Date Received by Manufacturer 08/09/2026
Initial Report FDA Received Date09/08/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured06/17/2019
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
Usage of Device Reuse
Patient Sequence Number1
Patient SexUnknown
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