VIDEO TELESCOPE "ENDOEYE HD II", 10 MM, 30°, AUTOCLAVABLE
Report
- Report Number
- 9610773-2026-00543
- Event Type
- Malfunction
- Date Received
- January 27, 2026
- Date of Event
- October 22, 2025
- Report Date
- January 27, 2026
- Manufacturer
- OLYMPUS WINTER & IBE GMBH
- Product Code
- HET
- UDI-DI
- 04042761074971
- PMA / PMN Number
- K190744
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- NL
- Reporter Occupation
- 003
Narratives
THE DEVICE WAS RETURNED TO OLYMPUS FOR INSPECTION. A ROOT CAUSE COULD NOT BE IDENTIFIED. BASED ON THE RESULTS OF THE INVESTIGATION, THE MOST PROBABLE CAUSE OF THE FIBRE BONDING IN THE OUTER TUBE ARE (DISTAL END) DAMAGE WAS TRACED TO COMPONENT FAILURE. THE MOST PROBABLE CAUSE OF THE MALFUNCTION THE LASER LIGHT CABLE (LLK) PLUG OF THE VIDEO CABLE SECTION WHICH CONTAINED FOREIGN MATERIAL WAS NOT ESTABLISHED. SHOULD ADDITIONAL RELEVANT INFORMATION BECOME AVAILABLE, A SUPPLEMENTAL REPORT WILL BE SUBMITTED. OLYMPUS WILL CONTINUE TO MONITOR FIELD PERFORMANCE FOR THIS DEVICE.
IT WAS OBSERVED THAT DURING THE DEVICE EVALUATION, THE RIGID VIDEO SCOPE EXHIBITED FIBRE BONDING IN THE OUTER TUBE AREA (DISTAL END) WAS DAMAGED; THE LASER LIGHT CABLE (LLK) PLUG OF THE VIDEO CABLE SECTION CONTAINED FOREIGN MATERIAL. THERE WAS NO PATIENT INVOLVEMENT.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 249194 | VIDEO TELESCOPE "ENDOEYE HD II", 10 MM, 30°, AUTOCLAVABLE | LAPAROSCOPE, GYNECOLOGIC | HET | OLYMPUS WINTER & IBE GMBH | WA50042A | 04042761074971 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | NA | Unknown |