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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BOSTON SCIENTIFIC CORPORATION FARASTAR; CARDIAC IRREVERSIBLE ELECTROPORATION SYSTEM GENERATOR

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BOSTON SCIENTIFIC CORPORATION FARASTAR; CARDIAC IRREVERSIBLE ELECTROPORATION SYSTEM GENERATOR Back to Search Results
Model Number M004PF41M444
Medical Device Problem Codes Unsealed Device Packaging (1444); Device Contamination with Chemical or Other Material (2944)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 07/30/2025
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
It was indicated that the device will not be returned for evaluation.If there is any further relevant information obtained, a supplemental medwatch will be filed.
 
Event or Problem Description
It was reported that for a pulse field ablation (pfa) procedure to treat an atrial fibrillation a farastar gen 2 connection cable was selected for use.During the procedure, when the device package box was opened the cable packaging was discovered to be partially open.The device was replaced, and the procedure was completed successfully.No patient complications were reported.The device isn't expected to return for laboratory analysis.
 
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Brand Name
FARASTAR
Common Device Name
CARDIAC IRREVERSIBLE ELECTROPORATION SYSTEM GENERATOR
Manufacturer (Section D)
BOSTON SCIENTIFIC CORPORATION
300 boston scientific way
marlborough MA 01752
Manufacturer (Section G)
BOSTON SCIENTIFIC CORPORATION
302 parkway, global park
la aurora - heredia
CS  
Manufacturer Contact
mary crawford
4100 hamline avenue north
dc a330
saint paul, MN 55112
6514400979
MDR Report Key22879517
Report Number2124215-2025-59014
Device Sequence Number12184909
Product Code QZI
UDI-Device Identifier00191506041663
UDI-Public(01)00191506041663(17)260512(10)36496998
Combination Product (Y/N)N
Initial Reporter StateNY
Initial Reporter CountryUS
Number of Events Summarized1
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
Report Date (Section B) 08/22/2025
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 Date05/12/2026
Device Model NumberM004PF41M444
Device Catalogue NumberM004PF41M444
Device Lot Number0036496998
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 07/30/2025
Initial Report FDA Received Date08/22/2025
Date Device Manufactured05/12/2025
Is the Device Labeled for Single Use? (Y/N) Yes
Usage of Device Initial
Patient Sequence Number1
Patient SexUnknown
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