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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BAYLIS MEDICALE CIE INC VERSACROSS STEERABLE ACCESS SOLUTION; CATHETER, SEPTOSTOMY

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BAYLIS MEDICALE CIE INC VERSACROSS STEERABLE ACCESS SOLUTION; CATHETER, SEPTOSTOMY Back to Search Results
Model Number VSTK0116
Medical Device Problem Code Material Integrity Problem (2978)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 09/01/2025
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 the versacross steerable access solution was selected for use.It was noted that the versacross wire sheared off.No further details provided.No patient complications reported.The device is not expected to be returned for analysis.Medsun (b)(4).
 
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Brand Name
VERSACROSS STEERABLE ACCESS SOLUTION
Common Device Name
CATHETER, SEPTOSTOMY
Manufacturer (Section D)
BAYLIS MEDICALE CIE INC
5959 trans-canada highway
montreal H4T 1 A1
CA  H4T 1A1
Manufacturer (Section G)
BOSTON SCIENTIFIC CORPORATION
2775 matheson blvd east
mississauga, on L4W 4 P7
CA   L4W 4P7
Manufacturer Contact
mary crawford
4100 hamline avenue north
dc a330
saint paul, MN 55112
6514400979
MDR Report Key23329052
Report Number2124215-2025-74347
Device Sequence Number13222856
Product Code DXF
UDI-Device Identifier00685447019664
UDI-Public(01)00685447019664(17)280616(10)36896051
Combination Product (Y/N)N
Initial Reporter StateRI
Initial Reporter CountryUS
PMA/510(K) Number
K150709
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)Unknown
Reporter Type Manufacturer
Report Source Other
Initial Reporter Occupation Other
Type of Report Initial
Report Date (Section B) 10/17/2025
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 NumberVSTK0116
Device Catalogue NumberVSTK0116
Device Lot Number0036896051
Was Device Available for Evaluation? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 10/01/2025
Initial Report FDA Received Date10/17/2025
Date Device Manufactured06/17/2025
Is the Device Labeled for Single Use? (Y/N) Yes
Usage of Device Initial
Patient Sequence Number1
Patient Age82 YR
Patient SexMale
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