FDA Adverse Event
Injury
Summary report: N
OLYMPUS COLONOSCOPE
MDR report key: 25175675
·
Received May 14, 2026
Report
- Report Number
- MW5188265
- Event Type
- Injury
- Date Received
- May 14, 2026
- Date of Event
- May 6, 2026
- Report Date
- May 12, 2026
- Manufacturer
- OLYMPUS AIZU OLYMPUS CO., LTD.
- Product Code
- FDF
- Adverse Event
- Yes
- Product Problem
- Yes
- Report Source
- Voluntary report
- Reporter Location
- US
- Reporter Occupation
- NURSE
- Health Professional
- Yes
Narratives
Description of Event or Problem · 0
DURING A SCHEDULED COLONOSCOPY, THE MD WAS HAVING DIFFICULTY ADVANCING THE COLONOSCOPE. AFTER A FEW MINUTES OF ATTEMPTING TO ADVANCE THE SCOPE, THE PROVIDER REMOVED THE SCOPE TO REVEAL THAT THE SCOPE HAD BROKEN AND HAD EXPOSED WIRES. THIS RESULTED IN TISSUE DAMAGE AND PERFORATION OF SIGMOID, REQUIRING PATIENT TO UNDERGO SIGMOID COLECTOMY WITH COLOSTOMY CREATION. PRE-OP DIAGNOSIS OF SMALL DUODENAL ULCER, COLONOSCOPY PERFORMED.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 247392 | OLYMPUS COLONOSCOPE | COLONOSCOPE AND ACCESSORIES, FLEXIBLE/RIGID | FDF | OLYMPUS AIZU OLYMPUS CO., LTD. | CF-HQ190L |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 57 YR | Male | Hospitalization| R |