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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 H74939135202010
Medical Device Problem Codes Material Rupture (1546); Adverse Event Without Identified Device or Use Problem (2993)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 12/23/2025
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that balloon rupture occurred.The 99% stenosed target lesion was located in the moderately tortuous and severely calcified vessel of below the knee.A 2mm x 20mm x 143cm coyote es balloon catheter was advanced for dilation.During first inflation at 6 atmospheres for 5 seconds, the balloon ruptured.The device was removed using normal method without issue and the procedure was completed with a different device.There were no patient complications as a result of this event.
 
Additional Manufacturer Narrative
A2 - age at time of event: 18 years or older.E1 - initial reporter address 1: (b)(6).
 
Additional Manufacturer Narrative
A2 - age at time of event: 18 years or older.E1 - initial reporter address 1: (b)(6).E1 - initial reporter city: (b)(6).Investigation results: device technical analysis upon receipt at our post market quality assurance laboratory, the outer shaft, inner shaft, balloon and tip were visually and microscopically examined.Visual examination showed the balloon had a rupture and a kink on the inner shaft at 2cm from the tip.Microscopic examination revealed that the balloon ruptured along the proximal marker band area.No other issues were identified during the product analysis.Device history record (dhr) review it was confirmed this device met manufacturing specifications prior to distribution and there were no manufacturing deviations that could have contributed to the reported event.Labeling review of the instructions for use (ifu) confirmed that the content was sufficient and did not contribute to the reported event; therefore, no updates are required to the document at this time.Investigation conclusion based on a thorough review of the reported complaint, boston scientific has assigned an investigation conclusion code of unable to exclude device problem.
 
Event or Problem Description
It was reported that balloon rupture occurred.The 99% stenosed target lesion was located in the moderately tortuous and severely calcified vessel of below the knee.A 2mm x 20mm x 143cm coyote es balloon catheter was advanced for dilation.During first inflation at 6 atmospheres for 5 seconds, the balloon ruptured.The device was removed using normal method without issue 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
mark mischke
4100 hamline ave n
arden hills, MN 55112
7634941632
MDR Report Key24109251
Report Number2124215-2026-03372
Device Sequence Number17589849
Product Code LIT
UDI-Device Identifier08714729767176
UDI-Public(01)08714729767176(17)280901(10)37346664
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
Initial Reporter Occupation Physician
Type of Report Initial,Followup
Report Date (Section B) 04/06/2026
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 Model NumberH74939135202010
Device Catalogue NumberH74939135202010
Device Lot Number0037346664
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 12/24/2025
Supplement Date Received by Manufacturer03/20/2026
Initial Report FDA Received Date01/19/2026
Supplement Report FDA Received Date04/06/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured09/02/2025
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 Number1
Concomitant Medical Products
and Therapy/Usage Dates
GUIDEWIRE: GLADIUS; GUIDEWIRE: GLADIUS; INFLATION DEVICE: GM30; INFLATION DEVICE: GM30; INTRODUCER SHEATH: TERUMO; INTRODUCER SHEATH: TERUMO; MICRO CATHETER: SARGENT; MICRO CATHETER: SARGENT
Patient SexUnknown
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