MAUDE Adverse Event Report: BOSTON SCIENTIFIC CORPORATION CAPIO SLIM; SPECIALIZED SURGICAL INSTRUMENTATION FOR USE WITH UROGYNECOLOGIC SURGICAL MESH

Model Number	M0068318261
Medical Device Problem Codes	Use of Device Problem (1670); Detachment of Device or Device Component (2907); Device-Device Incompatibility (2919)
Health Effect - Clinical Code	No Clinical Signs, Symptoms or Conditions (4582)
Date of Event	07/10/2025
Type of Reportable Event	Malfunction
Additional Manufacturer Narrative
Block h6: device code a0501 captures the reportable event of dart detachment.
Event or Problem Description
It was reported that during an anterior-posterior repair and sacrospinous ligament suspension procedure using a capio slim device, the dart detached while being loaded into the capio carrier.A second capio slim device was used to successfully complete the procedure.No patient complications were reported.
Event or Problem Description
It was reported that during an anterior-posterior repair and sacrospinous ligament suspension procedure using a capio slim device, the dart detached while being loaded into the capio carrier.A second capio slim device was used to successfully complete the procedure.No patient complications were reported.
Additional Manufacturer Narrative
Upon receipt at our quality assurance laboratory, this capio device underwent a thorough analysis.Visual inspection of the device did not reveal any damages/defect.During functional inspection, the carrier was able to move in and out; after deploying the carrier, the cage was able to catch the suture.Based on the information available and analysis results, the reported allegations of the device failing to load the suture, cage not catching the needle, and dart detaching could not be confirmed through product analysis.A conclusion code of no problem detected was assigned to this investigation since after visual and functional inspections in the complaint device it was not possible to identify any evidence of either the alleged issue or any defect on the device.Device code a0501 captures the reportable event of dart detachment.

• Brand Name: CAPIO SLIM
• Common Device Name: SPECIALIZED SURGICAL INSTRUMENTATION FOR USE WITH UROGYNECOLOGIC SURGICAL MESH
• 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: farshad fahimi ; 4100 hamline avenue north; building c; saint paul, MN 55112
• MDR Report Key: 22738370
• Report Number: 2124215-2025-51371
• Device Sequence Number: 12567279
• Product Code: PWI
• UDI-Device Identifier: 08714729842224
• UDI-Public: (01)08714729842224(10)35454592
• Combination Product (Y/N): N
• Initial Reporter State: WI
• Initial Reporter Country: US
• PMA/510(K) Number: K172060
• 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): 01/20/2026

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 Number: M0068318261
• Device Catalogue Number: 831-826
• Device Lot Number: 0035454592
• 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: 07/11/2025
• Supplement Date Received by Manufacturer: 01/05/2026
• Initial Report FDA Received Date: 08/07/2025
• Supplement Report FDA Received Date: 01/20/2026
• Was Device Evaluated by Manufacturer? (Y/N): Yes
• Date Device Manufactured: 12/09/2024
• 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