VIDEO TELESCOPE "ENDOEYE HD II", 10 MM, 30°, AUTOCLAVABLE
Report
- Report Number
- 9610773-2026-00606
- Event Type
- Malfunction
- Date Received
- January 29, 2026
- Date of Event
- November 3, 2025
- Report Date
- January 29, 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
- FI
- Reporter Occupation
- 003
Narratives
THE DEVICE WAS RETURNED TO OLYMPUS FOR INSPECTION. A ROOT CAUSE COULD NOT BE IDENTIFIED. BASED ON THE INVESTIGATION RESULTS, THE MOST PROBABLE CAUSE OF THE SCRATCHES ON THE COVER GLASS OF THE INSERTION TUBE WAS TRACED TO COMPONENT FAILURE. THE MOST PROBABLE CAUSE OF THE FOREIGN MATERIAL PRESENT ON THE LASER LIGHT CABLE (LLK) PLUG OF THE VIDEO CABLE SECTION WAS NOT BE 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 LAPAROSCOPE HAD SCRATCHES ON THE COVER GLASS OF THE INSERTION SECTION; FOREIGN MATERIAL WAS PRESENT ON THE LASER LIGHT CABLE (LLK) PLUG OF THE VIDEO CABLE SECTION. THERE WAS NO PATIENT INVOLVEMENT.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 269361 | 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 |