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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BOSTON SCIENTIFIC CORPORATION COYOTE? ES; CATHETER, ANGIOPLASTY, PERIPHERAL, TRANSLUMINAL

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BOSTON SCIENTIFIC CORPORATION COYOTE? ES; CATHETER, ANGIOPLASTY, PERIPHERAL, TRANSLUMINAL Back to Search Results
Model Number H74939135302010
Medical Device Problem Code Material Rupture (1546)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 12/03/2025
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that a balloon rupture occurred.The 90% stenosed target lesion was located in the moderately tortuous and severely calcified vessel.A 3mm x 20mm x 144cm coyote es mr balloon catheter was advanced for dilation.During the procedure, the balloon ruptured upon first inflation at the nominal burst pressure for 3 seconds.The device was removed without any problem, and the procedure was completed with a different device.There were no patient complications as a result of this event.
 
Additional Manufacturer Narrative
Device evaluated by mfr: the coyote es device was returned to our post market quality assurance laboratory.The outer shaft, inner shaft, balloon and tip were visually and microscopically examined.Visual examination revealed no damages.Microscopic examination revealed a longitudinal tear in the balloon 14mm from the tip and is approximately 14mm long.Inspection of the remainder of the device presented no other damage or irregularities.Product analysis confirmed there is a longitudinal tear in the balloon.This concludes the product analysis.
 
Event or Problem Description
It was reported that a balloon rupture occurred.The 90% stenosed target lesion was located in the moderately tortuous and severely calcified vessel.A 3mm x 20mm x 144cm coyote es mr balloon catheter was advanced for dilation.During the procedure, the balloon ruptured upon first inflation at the nominal burst pressure for 3 seconds.The device was removed without any problem, and the procedure was completed with a different device.There were no patient complications as a result of this event.
 
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Brand Name
COYOTE? ES
Common Device Name
CATHETER, ANGIOPLASTY, PERIPHERAL, TRANSLUMINAL
Manufacturer (Section D)
BOSTON SCIENTIFIC CORPORATION
300 boston scientific way
marlborough MA 01752
Manufacturer (Section G)
BOSTON SCIENTIFIC CORPORATION
two scimed place
maple grove MN 55311
Manufacturer Contact
rachel shields
4100 hamline ave n
arden hills, MN 55112
6512422111
MDR Report Key23900545
Report Number2124215-2025-93254
Device Sequence Number5081204
Product Code LIT
UDI-Device Identifier08714729767237
UDI-Public(01)08714729767237(17)260416(10)31435058
Combination Product (Y/N)N
Initial Reporter CountryJA
PMA/510(K) Number
K093636
Number of Events Summarized1
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) 02/15/2026
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 Expiration Date04/16/2026
Device Model NumberH74939135302010
Device Catalogue NumberH74939135302010
Device Lot Number0031435058
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 12/04/2025
Supplement Date Received by Manufacturer01/23/2026
Initial Report FDA Received Date12/26/2025
Supplement Report FDA Received Date02/15/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured04/17/2023
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 Number1
Patient SexUnknown
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