MAUDE Adverse Event Report: BOSTON SCIENTIFIC CORPORATION DIREXION?; CATHETER, CONTINUOUS FLUSH

Model Number	M001195240
Medical Device Problem Codes	Break (1069); Adverse Event Without Identified Device or Use Problem (2993)
Health Effect - Clinical Code	No Clinical Signs, Symptoms or Conditions (4582)
Date of Event	03/27/2025
Type of Reportable Event	Malfunction
Additional Manufacturer Narrative
G4 - premarket / 510(k): k142259, k163701.
Event or Problem Description
It was reported that shaft break occurred.The target lesion was located in the renal artery.A direxion microcatheter was selected for use in a renal arteriovenous malformation (avm) embolization.During the procedure, upon advancing/retracting and trying to access, the catheter broke.The device was simply removed in one piece.The procedure was completed with an alternate device.There were no patient complications as a result of this event.
Additional Manufacturer Narrative
G4 - premarket / 510(k): k142259, k163701.Device evaluated by mfr: the direxion was returned for analysis.Visual and microscope examination were performed.It revealed nickel shaft fracture and an inner lumen kink approximately 27.5cm from the strain relief.No other issues were identified with the device.
Event or Problem Description
It was reported that shaft break occurred.The target lesion was located in the renal artery.A direxion microcatheter was selected for use in a renal arteriovenous malformation (avm) embolization.During the procedure, upon advancing/retracting and trying to access, the catheter broke.The device was simply removed in one piece.The procedure was completed with an alternate device.There were no patient complications as a result of this event.

• Brand Name: DIREXION?
• Common Device Name: CATHETER, CONTINUOUS FLUSH
• Manufacturer (Section D): BOSTON SCIENTIFIC CORPORATION; 300 boston scientific way; marlborough MA 01752
• Manufacturer (Section G): BOSTON SCIENTIFIC CORPORATION; model farm road; cork T12 Y K88; EI T12 YK88
• Manufacturer Contact: rachel shields ; 4100 hamline ave n; arden hills, MN 55112 ; 6512422111
• MDR Report Key: 21873019
• Report Number: 2124215-2025-23971
• Device Sequence Number: 18117614
• Product Code: KRA
• UDI-Device Identifier: 08714729839354
• UDI-Public: (01)08714729839354(17)260115(10)33215224
• Combination Product (Y/N): N
• Initial Reporter State: NY
• Initial Reporter Country: US
• PMA/510(K) Number: K142259
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Serviced by Third Party (Y/N): Unknown
• Reporter Type: Manufacturer
• Report Source: Health Professional,Company Representative
• Initial Reporter Occupation: Physician
• Type of Report: Initial,Followup
• Report Date (Section B): 05/30/2025

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 Date: 01/15/2026
• Device Model Number: M001195240
• Device Catalogue Number: M001195240
• Device Lot Number: 0033215224
• Was Device Available for Evaluation?: Device Returned to Manufacturer
• Is the Reporter a Health Professional?: Yes
• Type of Report(Section G): Thirty-Day
• Initial Date Received by Manufacturer: 03/28/2025
• Supplement Date Received by Manufacturer: 05/05/2025
• Initial Report FDA Received Date: 04/21/2025
• Supplement Report FDA Received Date: 05/30/2025
• Was Device Evaluated by Manufacturer? (Y/N): Yes
• Date Device Manufactured: 01/16/2024
• 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 Number: 1
• Patient Sex: Unknown