FUJIFILM EB-530T

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2018-01-11 for FUJIFILM EB-530T manufactured by Fujifilm Corporation.

Event Text Entries

[97904506] Fujifilm medical systems u. S. A. , inc. (fmsu) was informed on october 25, 2017 by a service partner that a hospital had experienced several pseudomonas infections in their respiratory department and the doctors were concerned they could be from endoscopes, although the source of the infection had not been determined. Fujifilm attempted to contact the hospital at that time, but the hospital did not respond to the inquiry. On december 12, 2017, fmsu was informed by a service partner that the hospital had used the endoscope (eb530t serial (b)(4)) to obtain patient bal samples which resulted in positive pseudomonas cultures. The first instance of the subject endoscope scope bal sample resulting positive occurred on (b)(6) 2017. During the (b)(6) episode the endoscope was subsequently tested for contaminants and resulted positive for pseudomonas. The subject endoscope was then sent to a fujifilm authorized service facility for inspection and repair. The service facility completed the repair and returned the scope to the hospital on november 29, 2017. The endoscope was reprocessed and on (b)(6) 2017, was used and resulted in positive patient bal samples for pseudomonas. Although positive pseudomonas cultures were found to be associated with the subject endoscope, there are no reports of patient infections or of there being any adverse outcomes in patients undergoing bronchoscopy procedures with the subject endoscope. The endoscope was segregated and removed from use as soon as the hospital staff became aware of the positive cultures, during both instances. On (b)(6) 2017, after the second positive culture results were obtained, the hospital staff sent the endoscope to the fmsu service facility for additional inspection/evaluation by fujifilm. The endoscope is currently undergoing service and repair. Upon conclusion of the investigation, additional information will be reported in a follow up report.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number3001722928-2018-00001
MDR Report Key7182043
Date Received2018-01-11
Date of Report2018-03-01
Date Mfgr Received2017-12-12
Device Manufacturer Date2016-03-17
Date Added to Maude2018-01-11
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 FDA3
Event Location3
Manufacturer ContactMR. TETSUYA KAWANISHI
Manufacturer Street798 MIYANODAI KAISEI-MACHI
Manufacturer CityASHIGARAKAMI-GUN, KANAGAWA 258-8538
Manufacturer CountryJA
Manufacturer Postal258-8538
Manufacturer G1FUJIFILM CORPORATION
Manufacturer Street798 MIYANODAI KAISEI-MACHI
Manufacturer CityASHIGARAKAMI-GUN, KANAGAWA 258-8538
Manufacturer CountryJA
Manufacturer Postal Code258-8538
Single Use3
Previous Use Code3
Event Type3
Type of Report0

Device Details

Brand NameFUJIFILM
Generic NameVIDEO ENDOSCOPE, PRODUCT CODE
Product CodeGCT
Date Received2018-01-11
Returned To Mfg2017-12-21
Model NumberEB-530T
OperatorPHYSICIAN
Device AvailabilityR
Device AgeDA
Device Eval'ed by MfgrY
Device Sequence No1
Device Event Key0
ManufacturerFUJIFILM CORPORATION
Manufacturer Address798 MIYANODAI KAISEI-MACHI ASHIGARAKAMI-GUN, KANAGAWA 258-8538 JA 258-8538


Patients

Patient NumberTreatmentOutcomeDate
10 2018-01-11

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