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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BOSTON SCIENTIFIC CORPORATION STERLING SL; CATHETER, ANGIOPLASTY, PERIPHERAL, TRANSLUMINAL

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BOSTON SCIENTIFIC CORPORATION STERLING SL; CATHETER, ANGIOPLASTY, PERIPHERAL, TRANSLUMINAL Back to Search Results
Model Number H74939148401210
Medical Device Problem Code Material Rupture (1546)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 12/30/2024
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that balloon rupture occurred.The target lesion was located in the distal superficial femoral artery total.A 4.0mm x 120mm x 150cmsterling sl balloon catheter was advanced for dilation.During the procedure, the balloon bursted before it was inflated to nominal burst pressure (nbp).The procedure was completed with another of the same device.No complications were reported, and the patient was stable.
 
Additional Manufacturer Narrative
Device evaluated by mfr: the fg sterling sl was returned for analysis.The outer shaft, inner shaft, balloon and tip were visually and microscopically examined.Visual examination showed the balloon had a rupture.Microscopic examination revealed that the balloon ruptured longitudinal, measuring 30mm long.
 
Event or Problem Description
It was reported that balloon rupture occurred.The target lesion was located in the distal superficial femoral artery total.A 4.0mm x 120mm x 150cmsterling sl balloon catheter was advanced for dilation.During the procedure, the balloon bursted before it was inflated to nominal burst pressure (nbp).The procedure was completed with another of the same device.No complications were reported, and the patient was stable.It was further reported that target lesion was located in the mild tortuous and mild calcified.The device was removed slowly and carefully from the patient.
 
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Brand Name
STERLING SL
Common Device Name
CATHETER, ANGIOPLASTY, PERIPHERAL, TRANSLUMINAL
Manufacturer (Section D)
BOSTON SCIENTIFIC CORPORATION
300 boston scientific way
marlborough MA 01752
Manufacturer (Section G)
BOSTON SCIENTIFIC CORPORATION
two scimed place
maple grove MN 55311
Manufacturer Contact
mark mischke
4100 hamline ave n
arden hills, MN 55112
6128757234
MDR Report Key21210381
Report Number2124215-2025-02962
Device Sequence Number19785861
Product Code DQY
UDI-Device Identifier08714729782377
UDI-Public08714729782377
Combination Product (Y/N)N
Initial Reporter CountryTW
PMA/510(K) Number
K093720
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)Unknown
Reporter Type Manufacturer
Report Source Other,Foreign,Health Professional,Company Representative,Distributor
Initial Reporter Occupation Physician
Type of Report Initial,Followup
Report Date (Section B) 02/18/2025
1 Device was Involved in the Event
1 Patient was Involved in the Event
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Operator of Device Health Professional
Device Expiration Date02/22/2026
Device Model NumberH74939148401210
Device Catalogue NumberH74939148401210
Device Lot Number0033485394
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer01/16/2025
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 12/31/2024
Supplement Date Received by Manufacturer01/23/2025
Initial Report FDA Received Date01/22/2025
Supplement Report FDA Received Date02/18/2025
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured02/23/2024
Is the Device Labeled for Single Use? (Y/N) Yes
Is This a Single-Use Device that was
Reprocessed and Reused on a Patient? (Y/N)
No
Usage of Device Initial
Patient Sequence Number1
Patient SexUnknown
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