MAUDE Adverse Event Report: BOSTON SCIENTIFIC CORPORATION MAVERICK?; CATHETERS, TRANSLUMINAL CORONARY ANGIOPLASTY, PERCUTANEOUS

Model Number	H7493892815200
Medical Device Problem Codes	Nonstandard Device (1420); Material Rupture (1546)
Health Effect - Clinical Code	No Clinical Signs, Symptoms or Conditions (4582)
Date of Event	10/20/2025
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 balloon rupture occurred.The patient underwent percutaneous coronary intervention.The 85% stenosed target lesion was located in the severely tortuous and severely calcified left anterior descending artery.A 2.00mm x 15mm maverick balloon catheter was advanced for dilatation.However, during the procedure, the balloon burst due to severe calcification.The procedure was completed with a different device.There were no patient complications, and the patient was in good condition post-procedure.
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.Device evaluated by mfr.: the fg maverick 2 mr, 2.00mm x 15mm balloon catheter was returned for analysis.Visual, tactile, microscopic, and leakage analysis was performed on the device.Visual and tactile examination of the balloon profile showed that the balloon was subjected to positive pressure and was returned in a deflated state.A visual and tactile examination of the hypotube shaft identified multiple kinks along the hypotube shaft.A detailed microscopic examination of the balloon material identified no issues.A microscopic examination of the tip revealed no issues with the bumper tip.A microscopic examination of the distal and proximal markerbands identified no damage.A microscopic examination of the shaft polymer extrusion identified no kinks or damages.Leakage test was performed, and the device was attached to an encore inflation device.The balloon was inflated to rated burst pressure of 12 atmospheres with no issues.
Event or Problem Description
It was reported that balloon rupture occurred.The patient underwent percutaneous coronary intervention.The 85% stenosed target lesion was located in the severely tortuous and severely calcified left anterior descending artery.A 2.00mm x 15mm maverick balloon catheter was advanced for dilatation.However, during the procedure, the balloon burst due to severe calcification.The procedure was completed with a different device.There were no patient complications, and the patient was in good condition post-procedure.

• Brand Name: MAVERICK?
• Common Device Name: CATHETERS, TRANSLUMINAL CORONARY ANGIOPLASTY, PERCUTANEOUS
• Manufacturer (Section D): BOSTON SCIENTIFIC CORPORATION; 300 boston scientific way; marlborough MA 01752
• Manufacturer (Section G): BOSTON SCIENTIFIC CORPORATION; pmt 741 persiaran cassia selat; bandarcassia, pulau pinan 14110 ; MY 14110
• Manufacturer Contact: mark mischke ; 4100 hamline ave n; arden hills, MN 55112 ; 7634941632
• MDR Report Key: 23521619
• Report Number: 2124215-2025-81257
• Device Sequence Number: 15885974
• Product Code: LOX
• UDI-Device Identifier: 08714729370062
• UDI-Public: (01)08714729370062(17)271209(10)35445454
• Combination Product (Y/N): N
• Initial Reporter Country: KS
• PMA/510(K) Number: P860019
• Number of Events Summarized: 1
• 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): 01/12/2026

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 Number: H7493892815200
• Device Catalogue Number: H7493892815200
• Device Lot Number: 0035445454
• 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: 10/21/2025
• Supplement Date Received by Manufacturer: 12/22/2025
• Initial Report FDA Received Date: 11/11/2025
• Supplement Report FDA Received Date: 01/12/2026
• Was Device Evaluated by Manufacturer? (Y/N): Yes
• Date Device Manufactured: 12/09/2024
• 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 Number: 1
• Patient Age: 65 YR
• Patient Sex: Female