| Model Number |
M00584150 |
| Medical Device Problem Codes |
Break (1069); Adverse Event Without Identified Device or Use Problem (2993)
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| Health Effect - Clinical Code |
No Clinical Signs, Symptoms or Conditions (4582)
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| Date of Event |
11/06/2025
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Type of Reportable Event
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Malfunction
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Event or Problem Description
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It was reported to boston scientific corporation that a truetome 49 was used in the common bile duct during an endoscopic retrograde cholangiopancreatography (ercp) procedure to treat bile duct stones performed on (b)(6) 2025.During the procedure, while doing the duodenal papilla incision, as the device was electrified, the cutting wire fractured.The procedure was completed with another truetome 49.No further information has been obtained despite good faith efforts there were no patient complications reported as a result of this event.The patient condition following procedure was stable.
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Additional Manufacturer Narrative
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Block h6: imdrf device code a0401 captures the reportable event of cutting wire break.
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Additional Manufacturer Narrative
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Block h6: imdrf device code a0401 captures the reportable event of cutting wire break.Block h11: investigation results: the returned truetome 49 was analyzed, and a visual inspection found that the cutting wire was blackened, kinked and broken at 3 mm from the proximal pierce hole.No other problems with the device were noted.With all the available information, boston scientific concludes the reported event of cutting wire break was confirmed.The results of the analysis performed on the returned device found that the cutting wire was kinked and broken at 3 mm from the proximal pierce hole.It is most likely that procedural or anatomical factors encountered during the use of the device could have affected the device performance and its integrity.The break in the cutting wire could have been generated if there was contact between the device and the scope during energization or if the device exceeded the maximum of voltage during procedure.Also, energizing the device prior to performing sphincterotomy can compromise the cutting wires integrity, causing premature cutting wire fatigue.Once the cutting wire breaks, any attempt to remove the device from the scope can bend the cutting wire as observed in the product analysis.The investigation findings and all information available concludes the most probable root cause is an adverse event related to procedure.A review of the manufacturing documentation for this device revealed that no anomalies or deviations related to the event occurred during manufacturing.
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Event or Problem Description
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It was reported to boston scientific corporation that a truetome 49 was used in the common bile duct during an endoscopic retrograde cholangiopancreatography (ercp) procedure to treat bile duct stones performed on (b)(6) 2025.During the procedure, while doing the duodenal papilla incision, as the device was electrified, the cutting wire fractured.The procedure was completed with another truetome 49.No further information has been obtained despite good faith efforts.There were no patient complications reported as a result of this event.The patient condition following procedure was stable.
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Search Alerts/Recalls
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