OLYMPUS SIGMOIDOFIBERSCOPE OSF-3

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 05,06 report with the FDA on 2010-08-18 for OLYMPUS SIGMOIDOFIBERSCOPE OSF-3 manufactured by Olympus Medical Systems Corp.

Event Text Entries

[15561226] User facility personnel reported that several patients had reportedly complained of an allergic reaction following sigmoidoscopy over a period of several months. Olympus was informed that sigmoidoscopes at the user facility were not being reprocessed in accordance with the instructions for use, and the user facility was significantly deviating from the recommended cleaning instructions including not performing pre-cleaning, leak testing, nor completely submerging the endoscope into reprocessing chemicals. The user facility was also reportedly insufficiently brushing and flushing the sigmoidoscopes channels, and was exposing the devices to reprocessing chemicals for varying lengths of time.
Patient Sequence No: 1, Text Type: D, B5


[15986647] Olympus contacted the user facility via telephone and in writing to obtain add'l info regarding this report, but only limited info was provided. Olympus was informed that the subject device of this report was not used in any of the examinations where patients were said to have developed allergic reactions following sigmoidoscopy. The device referenced in this report was not returned to olympus for eval. An olympus endoscopy support specialist (ess) visited the user facility to obtain more info, and to assess the reprocessing practices at the user facility. The ess reported that conflicting info was provided to him by different staff members at the user facility. However, the ess determined that based on the info provided, that user facility personnel were not reprocessing their sigmoidoscopes in accordance with the recommended reprocessing protocol. The ess provided inservice training regarding appropriate reprocessing of endoscopes and provided educational materials. The user facility is reportedly purchasing add'l equipment and reprocessing supplies including an automated endoscope reprocessor (aer). This report is being submitted as an mdr in an abundance of caution. Cross reference mfr report number: 8010047-2010-00161 for a related report.
Patient Sequence No: 1, Text Type: N, H10


MAUDE Entry Details

Report Number8010047-2010-00162
MDR Report Key1812578
Report Source05,06
Date Received2010-08-18
Date of Report2010-07-20
Date Mfgr Received2010-07-20
Date Added to Maude2011-03-17
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional3
Initial Report to FDA3
Report to FDA0
Event Location0
Manufacturer ContactLAURA STORMS-TYLER
Manufacturer Street2400 RINGWOOD AVE
Manufacturer CitySAN JOSE CA 95131
Manufacturer CountryUS
Manufacturer Postal95131
Manufacturer Phone4848965688
Manufacturer G1OLYMPUS MEDICAL SYSTEMS CORP
Manufacturer Street2951 ISHIKAWA-CHO
Manufacturer CityHACHIOJI-SHI, TOKYO 192-8507
Manufacturer CountryJA
Manufacturer Postal Code192-8507
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameOLYMPUS SIGMOIDOFIBERSCOPE
Generic NameSIGMOIDOFIBERSCOPE
Product CodeFAM
Date Received2010-08-18
Model NumberOSF-3
Lot NumberNA
Device AvailabilityN
Device AgeDA
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerOLYMPUS MEDICAL SYSTEMS CORP
Manufacturer Address2951 ISHIKAWA-CHO HACHIOJI-SHI, TOKYO 192-8507 JA 192-8507


Patients

Patient NumberTreatmentOutcomeDate
10 2010-08-18

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