FDA Adverse Event Malfunction Summary report: N

VIDEO TELESCOPE "ENDOEYE HD II", 5.4 MM, 30°, AUTOCLAVABLE

MDR report key: 24744800 · Received March 31, 2026

Report

Report Number
9610773-2026-02571
Event Type
Malfunction
Date Received
March 31, 2026
Date of Event
January 26, 2026
Report Date
March 31, 2026
Manufacturer
OLYMPUS WINTER & IBE GMBH
Product Code
HET
UDI-DI
04042761075015
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, THE MOST PROBABLE CAUSE OF THE INADEQUATE DIELECTRIC STRENGTH WAS DAMAGE TO THE OUTER TUBE. HOWEVER, THE CAUSE OF THE FOREIGN MATERIAL OBSERVED IN THE LASER LIGHT CABLE (LLK PLUG) OF THE VIDEO CABLE SECTION 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 RIGID VIDEO LAPAROSCOPE EXHIBITED INADEQUATE DIELECTRIC STRENGTH, AND 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
806016 VIDEO TELESCOPE "ENDOEYE HD II", 5.4 MM, 30°, AUTOCLAVABLE RIGID VIDEO LAPAROSCOPE HET OLYMPUS WINTER & IBE GMBH WA50052A 04042761075015

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown