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