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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BOSTON SCIENTIFIC CORPORATION CRE PRO; CATHETER, BILIARY, DIAGNOSTIC

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BOSTON SCIENTIFIC CORPORATION CRE PRO; CATHETER, BILIARY, DIAGNOSTIC Back to Search Results
Model Number M00558610
Medical Device Problem Codes Burst Container or Vessel (1074); Leak/Splash (1354)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 07/24/2025
Type of Reportable Event Malfunction
Event or Problem Description
It was reported to boston scientific corporation that a cre pro wireguided dilatation balloon was used in the bile duct papillary orifice during an endoscopic retrograde cholangiopancreatography (ercp) procedure to treat bile duct stones performed on (b)(6) 2025.During the procedure, the dilated balloon burst at 3 atm, and the contrast agent leaked out at the pre-dilated papillary opening of the bile duct.It was reported that no piece of the balloon detached and fell inside the patient.The procedure was completed with another of the same device.There were no patient complications reported as a result of this event and the patient's condition at the conclusion of the procedure was reported to be stable.
 
Additional Manufacturer Narrative
Block e1: the initial reporter facility name is (b)(6); reported here as the name exceeded character limit for designated field.Block h6: imdrf device code a0402 captures the reportable event of balloon burst.
 
Event or Problem Description
It was reported to boston scientific corporation that a cre pro wireguided dilatation balloon was used in the bile duct papillary orifice during an endoscopic retrograde cholangiopancreatography (ercp) procedure to treat bile duct stones performed on (b)(6) 2025.During the procedure, the dilated balloon burst at 3 atm, and the contrast agent leaked out at the pre-dilated papillary opening of the bile duct.It was reported that no piece of the balloon detached and fell inside the patient.The procedure was completed with another of the same device.There were no patient complications reported as a result of this event and the patient's condition at the conclusion of the procedure was reported to be stable.
 
Additional Manufacturer Narrative
Block e1: the initial reporter facility name is (b)(6); reported here as the name exceeded character limit for designated field.Block h6: imdrf device code a0402 captures the reportable event of balloon burst.Block h11: investigation results the returned cre pro wireguided dase dilatation balloon was analyzed, and a visual and microscopic inspection found no problem with the device.Functional test was performed, and the balloon was inflated without problem and was able to hold pressure.No other problems with the device were noted.With all the available information, boston scientific concludes the reported event of balloon burst was not confirmed.The returned device reveals that the balloon was able to be inflated without any problem.Therefore, the most probable root cause is no problem detected.
 
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Brand Name
CRE PRO
Common Device Name
CATHETER, BILIARY, DIAGNOSTIC
Manufacturer (Section D)
BOSTON SCIENTIFIC CORPORATION
300 boston scientific way
marlborough MA 01752
Manufacturer (Section G)
BOSTON SCIENTIFIC CORK LIMITED
cork business technology park
model farm road
cork T12 Y K88
EI   T12 YK88
Manufacturer Contact
christina lam
300 boston scientific way
marlborough, MA 01752
9145716918
MDR Report Key22913350
Report Number3005099803-2025-04127
Device Sequence Number13025346
Product Code FGE
UDI-Device Identifier08714729797494
UDI-Public(01)08714729797494(17)271016(10)35075758
Combination Product (Y/N)N
Initial Reporter CountryCH
PMA/510(K) Number
K112994
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,Distributor
Initial Reporter Occupation Physician
Type of Report Initial,Followup
Report Date (Section B) 10/31/2025
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 NumberM00558610
Device Catalogue NumberM00558610
Device Lot Number0035075758
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 08/01/2025
Supplement Date Received by Manufacturer10/06/2025
Initial Report FDA Received Date08/28/2025
Supplement Report FDA Received Date10/31/2025
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured10/16/2024
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 Number1
Patient Age62 YR
Patient SexFemale
Patient Weight55 KG
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