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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BOSTON SCIENTIFIC CORPORATION SYNERGY MEGATRON?; CORONARY DRUG-ELUTING STENT

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BOSTON SCIENTIFIC CORPORATION SYNERGY MEGATRON?; CORONARY DRUG-ELUTING STENT Back to Search Results
Model Number H7493942828350
Medical Device Problem Codes Fracture (1260); Failure to Advance (2524)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 06/16/2025
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
Good faith effort attempts were made to try and retrieve additional details regarding the reported event, but further information was unable to be obtained.
 
Event or Problem Description
It was reported that stent fracture occurred.The 50-60% stenosed target lesion was located in a moderately tortuous and severely calcified coronary artery.A 3.50 x 28mm synergy megatron drug-eluting stent was advanced for treatment.However, a stent strut broke when trying to cross the calcified lesion.The procedure was completed using an alternative device.There were no patient complications reported.
 
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Brand Name
SYNERGY MEGATRON?
Common Device Name
CORONARY DRUG-ELUTING STENT
Manufacturer (Section D)
BOSTON SCIENTIFIC CORPORATION
300 boston scientific way
marlborough MA 01752
Manufacturer (Section G)
BOSTON SCIENTIFIC CORPORATION
ballybrit business park
galway
EI  
Manufacturer Contact
mark mischke
4100 hamline ave n
arden hills, MN 55112
7634941632
MDR Report Key22486844
Report Number2124215-2025-42992
Device Sequence Number8544733
Product Code NIQ
UDI-Device Identifier08714729985730
UDI-Public(01)08714729985730(17)270211(10)35929853
Combination Product (Y/N)Y
Initial Reporter StatePR
PMA/510(K) Number
P150003
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
Report Date (Section B) 07/11/2025
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 NumberH7493942828350
Device Catalogue NumberH7493942828350
Device Lot Number0035929853
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 06/16/2025
Initial Report FDA Received Date07/11/2025
Date Device Manufactured02/11/2025
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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