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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: Olympus Winter & Ibe GmbH Berlin Facility HF unit "ESG-400"; Electrosurgical generator ESG-400

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Olympus Winter & Ibe GmbH Berlin Facility HF unit "ESG-400"; Electrosurgical generator ESG-400 Back to Search Results
Model Number WB91051W
Medical Device Problem Code Communication or Transmission Problem (2896)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Type of Reportable Event Malfunction
Event or Problem Description
The customer reported an error e433 during setup/inspection for use on an olympus electrosurgical generator esg-400.No patient harm was reported.
 
Additional Manufacturer Narrative
The investigation is ongoing.A supplemental report will be submitted when the investigation is completed or if additional information becomes available.
 
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Brand Name
HF unit "ESG-400"
Common Device Name
Electrosurgical generator ESG-400
Manufacturer (Section D)
Olympus Winter & Ibe GmbH Berlin Facility
rheinstrasse 8
teltow, brandenburg 14513
GM  14513
Manufacturer (Section G)
Olympus Winter & Ibe GmbH Berlin Facility
rheinstrasse 8
teltow, brandenburg 14513
GM   14513
Manufacturer Contact
todd brill
800 west park drive
westborough, MA 01581
+1(508)207-7661
MDR Report Key50845704
Report Number3003724334-2026-00496
Device Sequence Number13331681
Product Code GEI
UDI-Device Identifier04042761076838
UDI-Public04042761076838
Combination Product (Y/N)N
Initial Reporter CountryBR
PMA/510(K) Number
K203682
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source Foreign,User Facility
Type of Report Initial
Report Date (Section B) 09/21/2026
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 NumberWB91051W
Was Device Available for Evaluation? Yes
Date Returned to Manufacturer09/11/2026
Is the Reporter a Health Professional? No
Initial Date Received by Manufacturer 09/01/2026
Initial Report FDA Received Date09/21/2026
Was Device Evaluated by Manufacturer? (Y/N) No
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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