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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 Codes Crack (1135); Material Fragmentation (1261)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 08/21/2026
Type of Reportable Event Malfunction
Event or Problem Description
The customer reported flaking at the distal tip during reprocessing.The issue involved an olympus rhino laryngo videoscope.Additionally, during the device analysis, the olympus service repair technician indicated that the distal sheath was cracked with exposed threads.There was no patient involvement.
 
Additional Manufacturer Narrative
The device was returned to olympus for inspection and the reported failure was confirmed.There was evidence of cracked distal sheath cover glue with exposed threads.A root cause could not be identified.Based on the results of the investigation, it is likely the following led to the malfunction: a degradation problem identified.The most probable cause of the degradation problem was due to a cause traced to component failure, which is an 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 Key50772585
Report Number3002808148-2026-32283
Device Sequence Number10538415
Product Code EOB
UDI-Device Identifier04953170411403
UDI-Public04953170411403
Combination Product (Y/N)N
Initial Reporter StateOR
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 Health Professional,User Facility
Initial Reporter Occupation Administrator/Supervisor
Type of Report Initial
Report Date (Section B) 09/15/2026
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 NumberENF-VH
Was Device Available for Evaluation? Yes
Date Returned to Manufacturer08/25/2026
Is the Reporter a Health Professional? No
Initial Date Received by Manufacturer 08/24/2026
Initial Report FDA Received Date09/15/2026
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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