FDA Adverse Event Malfunction Summary report: N

EVIS EXERA III COLONOVIDEOSCOPE

MDR report key: 23949717 · Received January 2, 2026

Report

Report Number
9610595-2026-00530
Event Type
Malfunction
Date Received
January 2, 2026
Date of Event
November 21, 2025
Report Date
January 22, 2026
Manufacturer
AIZU OLYMPUS CO., LTD.
Product Code
FDF
UDI-DI
04953170305139
PMA / PMN Number
K131780
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
SZ
Reporter Occupation
NURSE
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

THE INVESTIGATION IS ONGOING. A SUPPLEMENTAL REPORT WILL BE SUBMITTED WHEN THE INVESTIGATION IS COMPLETED OR IF ADDITIONAL INFORMATION BECOMES AVAILABLE.

Additional Manufacturer Narrative · 0

THIS REPORT IS BEING SUPPLEMENTED TO PROVIDE ADDITIONAL INFORMATION BASED ON THE RESULTS OF THIRD-PARTY TESTING, THE DEVICE EVALUATION AND THE COMPLAINT INVESTIGATION. THIS REPORT IS RELATED TO MFRS: 9610595-2026-00506 (2/9). 9610595-2026-00535 (3/9). 9610595-2026-00530 (4/9). 9610595-2026-00547 (5/9). 9610595-2026-00546 (6/9). 9610595-2026-00227 (7/9). 9610595-2026-00545 (8/9). 9610595-2026-00485 (9/9). ADDITIONALLY, THE FOLLOWING FIELDS HAVE BEEN CORRECTED: B5, H6. ADDITIONAL INFORMATION FIELDS: D8, H3, H4. OLYMPUS PROVIDED THE FOLLOWING RESULT OF THE CULTURE TEST, PERFORMED AT THE THIRD-PARTY LABS: SAMPLING DATE: (B)(6) 2025. SAMPLING FROM: AIR/WATER CHANNEL, AUXILIARY CHANNEL. CFU: <1CFU. BACTERIAL IDENTIFICATION: N/A. SAMPLING FROM: SUCTION CHANNEL. CFU: 1CFU. BACTERIAL IDENTIFICATION: MICROCOCCUS LUTEUS/LYLAE. SAMPLING FROM: INSTRUMENT CHANNEL. CFU: 1CFU. BACTERIAL IDENTIFICATION: ROSSELLOMOREA SP. THE DEVICE WAS EVALUATED WHERE AN ADDITIONAL POTENTIAL ADVERSE EVENT WAS CONFIRMED WHERE FOREIGN MATERIAL WAS FOUND IN THE AUXILIARY WATER CHANNEL. BASED ON THE RESULTS OF THE INVESTIGATION, OLYMPUS CONFIRMED FOREIGN MATERIAL WAS PRESENT WITHIN THE DEVICE, BUT THE TYPE OF THE MATERIAL CANNOT BE IDENTIFIED HOWEVER, IT IS LIKELY THE FOLLOWING LED TO THE MALFUNCTION: THE FOREIGN MATERIAL WAS POSSIBLY NOT REMOVED COMPLETELY IF THE REPROCESSING STEPS WERE NOT CONDUCTED PROPERLY. REGARDING THE POSITIVE CULTURE ALLEGATION: BASED ON THE RESULTS OF THE INVESTIGATION AND BECAUSE THE USER CULTURE RESULTS WERE NOT SHARED, THE REPORTED EVENT COULD NOT BE CONFIRMED, AND A ROOT CAUSE COULD NOT BE DETERMINED. GROWTH OF MICROORGANISMS WERE REPORTED THROUGH CULTURE TESTING BY THE USER AFTER REPROCESSING. HOWEVER, WHEN OLYMPUS CULTURE TESTED AFTER REPROCESSING IN ACCORDANCE WITH THE INSTRUCTIONS FOR USE (IFU) BEFORE REPAIR, THE RESULTS CONFORMED TO THE REGULATION'S RECOMMENDATION. OLYMPUS WILL CONTINUE TO MONITOR FIELD PERFORMANCE FOR THIS DEVICE.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE COLONOVIDEOSCOPE TESTED POSITIVE FOR AN UNEXPECTED CONTAMINATION. THE ISSUE WAS FOUND DURING A ROUTINE CULTURE OF THE SCOPE. THE USER DID NOT REPORT ANY CONTAMINATION OR ANY OTHER SERIOUS DETERIORATION IN STATE OF HEALTH OF ANY PERSON, TO WHICH THE SCOPE COULD HAVE BEEN A CONTRIBUTORY CAUSE.

Description of Event or Problem · 0

THE CUSTOMER REPORTED HAVING USED THE COLONOVIDEOSCOPE ON A PATIENT WHILE AWAITING THE RESULTS FOR ROUTINE CULTURE TESTING. POSITIVE CULTURE TEST RESULTS WERE SUBSEQUENTLY RECEIVED. THE USER DID NOT REPORT ANY CONTAMINATION OR ANY OTHER SERIOUS DETERIORATION IN STATE OF HEALTH OF ANY PERSON, TO WHICH THE SCOPE COULD HAVE BEEN A CONTRIBUTORY CAUSE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
3326 EVIS EXERA III COLONOVIDEOSCOPE COLONOVIDEOSCOPE FDF AIZU OLYMPUS CO., LTD. CF-HQ190I 04953170305139

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown