FDA Adverse Event
Malfunction
Summary report: N
VIDEO TELESCOPE "ENDOEYE HD II", 10 MM, 30°, AUTOCLAVABLE
MDR report key: 24741386
·
Received March 31, 2026
Report
- Report Number
- 9610773-2026-02535
- Event Type
- Malfunction
- Date Received
- March 31, 2026
- Date of Event
- February 12, 2026
- Report Date
- March 31, 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
- GM
- Reporter Occupation
- 003
Narratives
Additional Manufacturer Narrative · 0
THE DEVICE WAS RETURNED TO OLYMPUS FOR INSPECTION. A ROOT CAUSE COULD NOT BE IDENTIFIED. BASED ON THE RESULTS OF THE INVESTIGATION, IT IS LIKELY THE LLK (LASER LIGHT CABLE) PLUG OF THE VIDEO CABLE SECTION HAD FOREIGN MATERIAL CAUSE COULD 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.
Description of Event or Problem · 0
IT WAS OBSERVED THAT DURING THE DEVICE EVALUATION, THE GYNECOLOGIC LAPAROSCOPE HAD LLK (LASER LIGHT CABLE) PLUG OF THE VIDEO CABLE SECTION HAD FOREIGN MATERIAL. THERE WAS NO PATIENT INVOLVEMENT.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 806978 | 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 |