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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BOSTON SCIENTIFIC CORPORATION JAGWIRE; ENDOSCOPIC GUIDEWIRE, GASTROENTEROLOGY-UROLOGY

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BOSTON SCIENTIFIC CORPORATION JAGWIRE; ENDOSCOPIC GUIDEWIRE, GASTROENTEROLOGY-UROLOGY Back to Search Results
Model Number M00556581
Medical Device Problem Code Peeled/Delaminated (1454)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 12/16/2025
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
Block e1: initial reporter's address is (b)(6); reported here as the initial reporter address exceeded the character limit for the designated field.Block h6: imdrf impact code f1001 captures the reportable event of aborted/cancelled procedure.
 
Event or Problem Description
Note: this report pertains to one of four jagwires used in the same patient and procedure.It was reported to boston scientific corporation that a jagwire was attempted to be used in the common bile duct (cbd) during an endoscopic retrograde cholangiopancreatography (ercp) procedure performed on (b)(6) 2025.During the procedure, while advancing the guidewire into the common bile duct, peeling occurred on the black part of the hydrophilic tip.The same problem occurred with the other three jagwires.Due to this problem, the procedure had to be terminated.There were no patient complications reported as a result of this event.
 
Event or Problem Description
Note: this report pertains to one of four jagwires used in the same patient and procedure.It was reported to boston scientific corporation that a jagwire was attempted to be used in the common bile duct (cbd) during an endoscopic retrograde cholangiopancreatography (ercp) procedure performed on (b)(6) 2025.During the procedure, while advancing the guidewire into the common bile duct, peeling occurred on the black part of the hydrophilic tip.The same problem occurred with the other three jagwires.Due to this problem, the procedure had to be terminated.There were no patient complications reported as a result of this event.
 
Additional Manufacturer Narrative
Block e1: initial reporter's address is (b)(6).Block h6: imdrf impact code f1001 captures the reportable event of aborted/cancelled procedure.Block h11: investigation results the device was not returned for analysis and was reported to be disposed; therefore, a technical analysis could not be performed.With all the available information, boston scientific concludes that the reported event of tip peeled could not be confirmed.The device was not returned for analysis and was reported to be disposed.Without analysis of the device, there is a lack of objective evidence, or descriptive conditions of the event required to determine a probable root cause of the event.Based on a thorough review of the reported complaint, boston scientific has assigned an investigation conclusion code of cause not established.A review of the device history record (dhr) was performed.The review of the dhr identified that there were no process related non-conformances, scrap, or rework performed during the production that could explain the event.The reviews ensure each device meets specification prior to release for use.There is no indication the device manufacturing process contributed to the reported complaint.Review of the instructions for use (ifu) confirmed there was relevant content and sufficient guidance with respect to the circumstances described within this complaint.No updates are required to the ifu as a result of this event.A risk review was completed and confirmed that the event of cancelled/rescheduled - post sedation/sedation unknown was defined in the risk documentation.This event type has been accounted for during product risk analysis to support acceptable risk benefit for the product.
 
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Brand Name
JAGWIRE
Common Device Name
ENDOSCOPIC GUIDEWIRE, GASTROENTEROLOGY-UROLOGY
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
christina lam
300 boston scientific way
marlborough, MA 01752
9145716918
MDR Report Key24049515
Report Number3005099803-2026-00171
Device Sequence Number10022867
Product Code OCY
UDI-Device Identifier08714729339151
UDI-Public(01)08714729339151(17)260228(10)31145598
Combination Product (Y/N)N
Initial Reporter CountryTU
PMA/510(K) Number
K141820
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) 04/24/2026
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 Date02/28/2026
Device Model NumberM00556581
Device Catalogue Number5658
Device Lot Number0031145598
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 12/24/2025
Supplement Date Received by Manufacturer04/07/2026
Initial Report FDA Received Date01/12/2026
Supplement Report FDA Received Date04/24/2026
Date Device Manufactured03/01/2023
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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