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U.S. Department of Health and Human Services

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

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BOSTON SCIENTIFIC CORPORATION SYNERGY? XD; CORONARY DRUG-ELUTING STENT Back to Search Results
Model Number H7493941812300
Medical Device Problem Codes Difficult to Remove (1528); Migration (4003)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 05/09/2025
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 removal difficulty and stent migration occurred.A 3.00 x 12mm synergy xd drug-eluting stent (des) was advanced and deployed.However, difficulty removing the stent delivery balloon was encountered, requiring withdrawal of the guide catheter from the descending aorta and the wire.Excellent angiographic results were observed.Weeks later, when the patient was admitted for coronary artery bypass grafting, the surgeon made an incision and found a stent floating freely, presumably the synergy xd.No additional details were provided.
 
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Brand Name
SYNERGY? XD
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 Key22963853
Report Number2124215-2025-61334
Device Sequence Number9113819
Product Code NIQ
UDI-Device Identifier08714729980957
UDI-Public(01)08714729980957(17)260715(10)34511689
Combination Product (Y/N)Y
Initial Reporter StateLA
Initial Reporter CountryUS
PMA/510(K) Number
P150003
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2025
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) 09/04/2025
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 Date07/15/2026
Device Model NumberH7493941812300
Device Catalogue NumberH7493941812300
Device Lot Number0034511689
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 08/13/2025
Initial Report FDA Received Date09/04/2025
Date Device Manufactured07/15/2024
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 SexUnknown
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