• Decrease font size
  • Return font size to normal
  • Increase font size
U.S. Department of Health and Human Services

MAUDE Adverse Event Report: OLYMPUS MEDICAL SYSTEMS CORP. FIBERSCOPE "CYF-5", EUROPEAN VERSION CYSTONEPHROFIBERSCOPE

  • Print
  • Share
  • E-mail
-
Super Search Devices@FDA
510(k) | DeNovo | Registration & Listing | Adverse Events | Recalls | PMA | HDE | Classification | Standards
CFR Title 21 | Radiation-Emitting Products | X-Ray Assembler | Medsun Reports | CLIA | TPLC
 

OLYMPUS MEDICAL SYSTEMS CORP. FIBERSCOPE "CYF-5", EUROPEAN VERSION CYSTONEPHROFIBERSCOPE Back to Search Results
Model Number CYF-5
Device Problem Microbial Contamination of Device (2303)
Patient Problem No Known Impact Or Consequence To Patient (2692)
Event Date 06/11/2019
Event Type  Malfunction  
Manufacturer Narrative

The subject device had not been returned to olympus medical systems corp(omsc). But was returned to olympus (b)(4). The subject device was sent to a third-party laboratory for additional microbiological testing. In the result of the additional microbiological testing, the subject device tested positive for staphylococcus coagulase negative(1 cfu/endoscope). The physical findings of the subject device were not reported. Omsc reviewed the manufacturing history(dhr) of the subject device and confirmed no irregularity. The exact cause of the reported event could not be conclusively determined at this time. If additional information is received, this report will be supplemented.

 
Event Description

Olympus was informed that as a result of microbiological testing by the user facility, the subject device repeatedly tested positive for the following bacteria. On (b)(6) 2019: the biopsy channel: unspecified bacteria(50 cfu/100ml). On (b)(6) 2019: the biopsy channel: unspecified bacteria(40 cfu/100ml). The subject device had been brushed manually using a non-olympus cleaning brush(prince medical, kit 1 clean: diametre 1. 8) and disinfected using non-olympus automated endoscope reprocessor (getinge, poka-yoke) with peracetic acid. After reprocessing, the subject device was stored in the storage cabinet(olympus). There was no report of patient infection associated with this report.

 
Manufacturer Narrative

This supplemental report is being submitted to provide additional information. The result of the additional microbiological testing didn't clear the (b)(6) guideline. The exact cause of the reported event could not be conclusively determined at this time. If additional information is received, this report will be supplemented.

 
Search Alerts/Recalls

  New Search  |  Submit an Adverse Event Report

Brand NameFIBERSCOPE "CYF-5", EUROPEAN VERSION
Type of DeviceCYSTONEPHROFIBERSCOPE
Manufacturer (Section D)
OLYMPUS MEDICAL SYSTEMS CORP.
2951 ishikawa-cho
hachioji-shi, tokyo-to 192-8 507
JA 192-8507
Manufacturer Contact
kazutaka matsumoto
2951 ishikawa-cho
hachioji-shi, tokyo-to 192-8-507
JA   192-8507
426425177
MDR Report Key8810159
MDR Text Key207925695
Report Number8010047-2019-02607
Device Sequence Number1
Product Code FAJ
Combination Product (Y/N)N
Reporter Country CodeFR
PMA/PMN NumberK032092
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type FOREIGN,HEALTH PROFESSIONAL,U
Reporter Occupation
Type of Report Initial,Followup
Report Date 07/22/2019
1 Device Was Involved in the Event
0 PatientS WERE Involved in the Event:
Date FDA Received07/21/2019
Is This A Product Problem Report? Yes
Device Operator HEALTH PROFESSIONAL
Device MODEL NumberCYF-5
Was Device Available For Evaluation? No
Is The Reporter A Health Professional? No
Was the Report Sent to FDA? No
Event Location No Information
Date Manufacturer Received07/22/2019
Was Device Evaluated By Manufacturer? Device Not Returned To Manufacturer
Date Device Manufactured11/05/2009
Is The Device Single Use? No
Is this a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Reuse

-
-