• Decrease font size
  • Return font size to normal
  • Increase font size
U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BOSTON SCIENTIFIC CORPORATION CRE PRO; CATHETER, BILIARY, DIAGNOSTIC

  • Print
  • Share
  • E-mail
-
Super Search Devices@FDA
510(k) | DeNovo | Registration & Listing | Adverse Events | Recalls | PMA | HDE | Classification | Standards
CFR Title 21 | Radiation-Emitting Products | X-Ray Assembler | Medsun Reports | CLIA | TPLC
 

BOSTON SCIENTIFIC CORPORATION CRE PRO; CATHETER, BILIARY, DIAGNOSTIC Back to Search Results
Model Number M00558680
Medical Device Problem Codes Inflation Problem (1310); Detachment of Device or Device Component (2907)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 12/18/2025
Type of Reportable Event Serious Injury
Additional Manufacturer Narrative
Block h6: imdrf device code a0501 captures the reportable event of balloon detachment.Imdrf impact code f2301 captures the reportable event of additional device required (grasping forceps).
 
Event or Problem Description
It was reported to boston scientific corporation that a cre pro wireguided dilatation balloon was used during a dilation procedure to treat benign stricture performed on an (b)(6) 2025.During the procedure, the balloon detached and failed to inflate.The device was retrieved using grasping forceps.The procedure was completed with another of the same device from different batch.There were no patient complications reported as a result of this event.
 
Additional Manufacturer Narrative
Block h6: imdrf device code a0501 captures the reportable event of balloon detachment.Imdrf impact code f2301 captures the reportable event of additional device required (grasping forceps).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 available information, boston scientific concludes the reported event of balloon detachment could not be confirmed.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 balloon detachment of device or device component 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.
 
Event or Problem Description
It was reported to boston scientific corporation that a cre pro wireguided dilatation balloon was used during a dilation procedure to treat benign stricture performed on (b)(6) 2025.During the procedure, the balloon detached and failed to inflate.The device was retrieved using grasping forceps.The procedure was completed with another of the same device from different batch.There were no patient complications reported as a result of this event.
 
Search Alerts/Recalls

  New Search  |  Submit an Adverse Event Report

Brand Name
CRE PRO
Common Device Name
CATHETER, BILIARY, DIAGNOSTIC
Manufacturer (Section D)
BOSTON SCIENTIFIC CORPORATION
300 boston scientific way
marlborough MA 01752
Manufacturer (Section G)
BOSTON SCIENTIFIC CORK LIMITED
cork business technology park
model farm road
cork T12 Y K88
EI   T12 YK88
Manufacturer Contact
christina lam
300 boston scientific way
marlborough, MA 01752
9145716918
MDR Report Key24064115
Report Number3005099803-2026-00195
Device Sequence Number9387536
Product Code FGE
UDI-Device Identifier08714729797562
UDI-Public(01)08714729797562(17)270726(10)34513746
Combination Product (Y/N)N
Initial Reporter CountryUK
PMA/510(K) Number
K112994
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
Initial Reporter Occupation Other Health Care Professional
Type of Report Initial,Followup
Report Date (Section B) 04/20/2026
1 Device was Involved in the Event
1 Patient was Involved in the Event
Is this an Adverse Event Report? Yes
Is this a Product Problem Report? Yes
Operator of Device Health Professional
Device Model NumberM00558680
Device Catalogue NumberM00558680
Device Lot Number0034513746
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 12/18/2025
Supplement Date Received by Manufacturer03/27/2026
Initial Report FDA Received Date01/13/2026
Supplement Report FDA Received Date04/20/2026
Date Device Manufactured07/26/2024
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 Number1
Outcome Attributed to Adverse Event Required Intervention;
Patient SexUnknown
-
-