FDA Adverse Event
Malfunction
Summary report: N
EVIS LUCERA ELITE GASTROINTESTINAL VIDEOSCOPE
MDR report key: 25311630
·
Received May 27, 2026
Report
- Report Number
- 9610595-2026-43197
- Event Type
- Malfunction
- Date Received
- May 27, 2026
- Report Date
- May 27, 2026
- Manufacturer
- AIZU OLYMPUS CO., LTD.
- Product Code
- FDS
- PMA / PMN Number
- N/A
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- JA
- Reporter Occupation
- OTHER
Narratives
Additional Manufacturer Narrative · 0
THE INVESTIGATION IS ONGOING. A SUPPLEMENTAL REPORT WILL BE SUBMITTED WHEN THE INVESTIGATION IS COMPLETED OR IF ADDITIONAL INFORMATION BECOMES AVAILABLE.
Description of Event or Problem · 0
THE CUSTOMER REPORTED A SCOPE CONNECTION ERROR DURING INSPECTION FOR USE INVOLVING AN OLYMPUS GASTROINTESTINAL VIDEOSCOPE. THERE WAS NO PATIENT INVOLVEMENT.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 409554 | EVIS LUCERA ELITE GASTROINTESTINAL VIDEOSCOPE | GASTROINTESTINAL VIDEOSCOPE | FDS | AIZU OLYMPUS CO., LTD. | GIF-XP290N |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 |