MAUDE Adverse Event Report: BOSTON SCIENTIFIC CORPORATION OPTICROSS? HD; CATHETER, ULTRASOUND, INTRAVASCULAR

Model Number	H74939352040
Medical Device Problem Codes	No Display/Image (1183); Nonstandard Device (1420); Detachment of Device or Device Component (2907)
Health Effect - Clinical Code	No Clinical Signs, Symptoms or Conditions (4582)
Date of Event	11/01/2025
Type of Reportable Event	Malfunction
Additional Manufacturer Narrative
B3 date of event was estimated based on the aware date as the event date was unknown.G4: premarket / 510(k) # k173284, k213593.Good faith effort attempts were made to try and retrieve additional details regarding the reported event, but further information was unable to be obtained.If additional details become available, a supplemental report will be submitted.
Event or Problem Description
It was reported that catheter issue occurred.An opticross hd imaging catheter was selected for ultrasound examination for the target lesion.During the procedure, imaging started and stopped on its own.Upon removal, the catheter tip was found broken.The device was removed in one piece.The procedure was completed using an alternative device, and no patient complications were reported.
Additional Manufacturer Narrative
B3 date of event was estimated based on the aware date as the event date was unknown.G4: premarket / 510(k) # k173284, k213593.Good faith effort attempts were made to try and retrieve additional details regarding the reported event, but further information was unable to be obtained.If additional details become available, a supplemental report will be submitted.The device was returned for analysis.Visual inspection revealed the sheath assembly was kinked.Microscopic inspection showed the guidewire exit port and the distal section of the tip were in good condition.Impedance testing showed an electrical open at the distal end of the catheter; 0-10 cm from the distal housing.
Event or Problem Description
It was reported that catheter issue occurred.An opticross hd imaging catheter was selected for ultrasound examination for the target lesion.During the procedure, imaging started and stopped on its own.Upon removal, the catheter tip was found broken.The device was removed in one piece.The procedure was completed using an alternative device, and no patient complications were reported.

• Brand Name: OPTICROSS? HD
• Common Device Name: CATHETER, ULTRASOUND, INTRAVASCULAR
• Manufacturer (Section D): BOSTON SCIENTIFIC CORPORATION; 300 boston scientific way; marlborough MA 01752
• Manufacturer (Section G): BOSTON SCIENTIFIC CORPORATION; 2546 calle primera; alajuela ; CS
• Manufacturer Contact: mark mischke ; 4100 hamline ave n; arden hills, MN 55112 ; 7634941632
• MDR Report Key: 23776983
• Report Number: 2124215-2025-87245
• Device Sequence Number: 21352193
• Product Code: OBJ
• UDI-Device Identifier: 08714729960737
• UDI-Public: (01)08714729960737(17)260619(10)36793247
• Combination Product (Y/N): N
• Initial Reporter State: LA
• Initial Reporter Country: US
• PMA/510(K) Number: K173284
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Serviced by Third Party (Y/N): Unknown
• Reporter Type: Manufacturer
• Report Source: Health Professional,Company Representative
• Initial Reporter Occupation: Nurse
• Type of Report: Initial,Followup
• Report Date (Section B): 12/16/2025

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 Date: 06/19/2026
• Device Model Number: H74939352040
• Device Catalogue Number: H74939352040
• Device Lot Number: 0036793247
• 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: 11/19/2025
• Supplement Date Received by Manufacturer: 12/15/2025
• Initial Report FDA Received Date: 12/11/2025
• Supplement Report FDA Received Date: 12/16/2025
• Was Device Evaluated by Manufacturer? (Y/N): Yes
• Date Device Manufactured: 06/19/2025
• 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 Sex: Unknown