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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BOSTON SCIENTIFIC CORPORATION ORISE? PROKNIFE; UNIT, ELECTROSURGICAL, ENDOSCOPIC (WITH OR WITHOUT ACCESSORIES)

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BOSTON SCIENTIFIC CORPORATION ORISE? PROKNIFE; UNIT, ELECTROSURGICAL, ENDOSCOPIC (WITH OR WITHOUT ACCESSORIES) Back to Search Results
Model Number M00519351
Medical Device Problem Code Unsealed Device Packaging (1444)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 07/07/2025
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
Block e1: initial reporter facility address: (b)(6).Block h6: imdrf device code a020503 captures the reportable event of seal compromised.
 
Event or Problem Description
It was reported to boston scientific corporation that an orise proknife was unpacked on (b)(6) 2025.During the unpacking of the device, it was observed that half of the sealing seal has peeled off.There was no patient involvement in this reported event.No further information has been obtained despite good faith efforts.
 
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Brand Name
ORISE? PROKNIFE
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
model farm road
cork T12 Y K88
EI   T12 YK88
Manufacturer Contact
arlene acevedo gutierrez
300 boston scientific way
marlborough, MA 01752
7877968283
MDR Report Key22724591
Report Number3005099803-2025-03875
Device Sequence Number12850196
Product Code KNS
UDI-Device Identifier08714729999881
UDI-Public(01)08714729999881(17)270407(10)36779398
Combination Product (Y/N)N
Initial Reporter CountryJA
PMA/510(K) Number
K200404
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)Unknown
Reporter Type Manufacturer
Report Source Other,Foreign,Company Representative,Distributor
Initial Reporter Occupation Non-Healthcare Professional
Type of Report Initial
Report Date (Section B) 08/06/2025
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 Other
Device Model NumberM00519351
Device Catalogue NumberM00519351
Device Lot Number0036779398
Was Device Available for Evaluation? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 07/07/2025
Initial Report FDA Received Date08/06/2025
Date Device Manufactured04/07/2025
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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