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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BOSTON SCIENTIFIC CORPORATION TRUETOME 39; UNIT, ELECTROSURGICAL, ENDOSCOPIC (WITH OR WITHOUT ACCESSORIES)

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BOSTON SCIENTIFIC CORPORATION TRUETOME 39; UNIT, ELECTROSURGICAL, ENDOSCOPIC (WITH OR WITHOUT ACCESSORIES) Back to Search Results
Model Number M00584190
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 06/02/2025
Type of Reportable Event Malfunction
Event or Problem Description
It was reported to boston scientific corporation that a truetome 39 was attempted to be used in the duodenum during an endoscopic retrograde cholangiopancreatography (ercp) procedure performed on (b)(6) 2025.During the procedure, when the physician bowed the truetome for the first time, the cutting wire at the distal tip broke.It was reported that no part of the cutting wire detached and fell into the patient.The procedure was completed with another truetome 39.There were no patient complications reported as a result of this event.
 
Additional Manufacturer Narrative
Block h6: imdrf device code a0401 captures the reportable event of cutting wire break.
 
Additional Manufacturer Narrative
H6: imdrf device code a0401 captures the reportable event of cutting wire break.H11: investigation results: the returned truetome 39 was analyzed, and a visual inspection found that the cutting wire was blackened, kinked and broken at 5 mm from the proximal pierce hole.No other problems with the device were noted.With all the available information, boston scientific concludes the reported event of cutting wire break was confirmed.The results of the analysis performed on the returned device found that the cutting wire was kinked and broken from the proximal pierce hole.It is most likely that procedural or anatomical factors encountered during the use of the device could have affected the device performance and its integrity.The break in the cutting wire could have been generated if there was contact between the device and the scope during energization or if the device exceeded the maximum of voltage during procedure.Also, energizing the device prior to performing sphincterotomy can compromise the cutting wires integrity, causing premature cutting wire fatigue.Once the cutting wire breaks, any attempt to remove the device from the scope can bend the cutting wire as observed in the product analysis.The investigation findings and all information available concludes the most probable root cause is an adverse event related to procedure.
 
Event or Problem Description
It was reported to boston scientific corporation that a truetome 39 was attempted to be used in the duodenum during an endoscopic retrograde cholangiopancreatography (ercp) procedure performed on (b)(6) 2025.During the procedure, when the physician bowed the truetome for the first time, the cutting wire at the distal tip broke.It was reported that no part of the cutting wire detached and fell into the patient.The procedure was completed with another truetome 39.There were no patient complications reported as a result of this event.
 
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Brand Name
TRUETOME 39
Common Device Name
UNIT, ELECTROSURGICAL, ENDOSCOPIC (WITH OR WITHOUT ACCESSORIES)
Manufacturer (Section D)
BOSTON SCIENTIFIC CORPORATION
300 boston scientific way
marlborough MA 01752
Manufacturer (Section G)
BOSTON SCIENTIFIC CORPORATION
2546 calle primera
alajuela
CS  
Manufacturer Contact
arlene acevedo gutierrez
300 boston scientific way
marlborough, MA 01752
7877968283
MDR Report Key22355828
Report Number3005099803-2025-02936
Device Sequence Number18332752
Product Code KNS
UDI-Device Identifier08714729827658
UDI-Public(01)08714729827658(17)270130(10)35746401
Combination Product (Y/N)N
Initial Reporter CountryTW
PMA/510(K) Number
K122203
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
Initial Reporter Occupation Physician
Type of Report Initial,Followup
Report Date (Section B) 08/28/2025
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 Model NumberM00584190
Device Catalogue NumberM00584190
Device Lot Number0035746401
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 06/03/2025
Supplement Date Received by Manufacturer07/31/2025
Initial Report FDA Received Date06/30/2025
Supplement Report FDA Received Date08/28/2025
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured01/30/2025
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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