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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BOSTON SCIENTIFIC CORPORATION VERSACROSS ACCESS SOLUTION; CATHETER, SEPTOSTOMY

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BOSTON SCIENTIFIC CORPORATION VERSACROSS ACCESS SOLUTION; CATHETER, SEPTOSTOMY Back to Search Results
Model Number VXSK0121
Medical Device Problem Code Material Integrity Problem (2978)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 10/06/2025
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that during farapulse procedure, a versacross access solution was selected for use.During preparation, it was noted that the back of rf wire was peeling off.Thus, the physician opted to open a replacement and the procedure was completed successfully.No patient complications occurred.The device is not expected to be returned for analysis (disposed).
 
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 during farapulse procedure, a versacross access solution was selected for use.During preparation, it was noted that the back of rf wire was peeling off.Thus, the physician opted to open a replacement and the procedure was completed successfully.No patient complications occurred.The device is not expected to be returned for analysis (disposed).
 
Additional Manufacturer Narrative
The device did not return for analysis.However, the reported allegation of insulation damage is confirmed based the media provided.
 
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Brand Name
VERSACROSS ACCESS SOLUTION
Common Device Name
CATHETER, SEPTOSTOMY
Manufacturer (Section D)
BOSTON SCIENTIFIC CORPORATION
300 boston scientific way
marlborough MA 01752
Manufacturer (Section G)
BOSTON SCIENTIFIC CORPORATION
multitenant #2, street #58 zon
cartago, 03 30106
CS   30106
Manufacturer Contact
mary crawford
4100 hamline avenue north
dc a330
saint paul, MN 55112
6514400979
MDR Report Key23373148
Report Number2124215-2025-76115
Device Sequence Number21149883
Product Code DXF
UDI-Device Identifier00685447019817
UDI-Public(01)00685447019817(17)280421(10)36734513
Combination Product (Y/N)N
Initial Reporter StateNY
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 Health Professional,Company Representative
Initial Reporter Occupation Physician
Type of Report Initial,Followup
Report Date (Section B) 12/17/2025
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 NumberVXSK0121
Device Catalogue NumberVXSK0121
Device Lot Number0036734513
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 10/06/2025
Supplement Date Received by Manufacturer11/28/2025
Initial Report FDA Received Date10/23/2025
Supplement Report FDA Received Date12/17/2025
Date Device Manufactured04/22/2025
Is the Device Labeled for Single Use? (Y/N) Yes
Usage of Device Initial
Patient Sequence Number1
Patient SexUnknown
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