MAUDE Adverse Event Report: BOSTON SCIENTIFIC CORPORATION CRE WIREGUIDED; COLONOSCOPE AND ACCESSORIES, FLEXIBLE/RIGID

Model Number	M00558400
Medical Device Problem Codes	Burst Container or Vessel (1074); Inflation Problem (1310); Material Integrity Problem (2978)
Health Effect - Clinical Code	No Clinical Signs, Symptoms or Conditions (4582)
Date of Event	12/24/2025
Type of Reportable Event	Malfunction
Additional Manufacturer Narrative
Block h6: imdrf device code a04 captures the reportable event of balloon damage.
Event or Problem Description
It was reported to boston scientific corporation that a cre wireguided dilatation balloon was used in the biliary tract during an endoscopic retrograde cholangiopancreatography (ercp) stone removal procedure to treat jaundice and lower abdominal pain performed on (b)(6) 2025.During the procedure, the balloon was damaged and it could not be properly inflated in the papilla.The procedure was completed with another cre wireguided dilatation balloon.No further information has been obtained despite good faith efforts.The reported event may suggest a balloon burst occurred during the procedure.There were no patient complications reported as a result of this event.The patient's condition at the conclusion of the procedure was reported to be stable.
Event or Problem Description
It was reported to boston scientific corporation that a cre wireguided dilatation balloon was used in the biliary tract during an endoscopic retrograde cholangiopancreatography (ercp) stone removal procedure to treat jaundice and lower abdominal pain performed on (b)(6) 2025.During the procedure, the balloon was damaged and it could not be properly inflated in the papilla.The procedure was completed with another cre wireguided dilatation balloon.There were no patient complications reported as a result of this event.The patient's condition at the conclusion of the procedure was reported to be stable.Additional information received on january 22, 2025.It was clarified that the damage observed on the balloon was a burst.
Additional Manufacturer Narrative
Block h6: imdrf device code a04 captures the reportable event of balloon damage.Block h2: additional information: block b5 (describe event or problem) and block h6 (device codes) block h11: investigation results the returned cre wireguided dilatation balloon was analyzed, and a visual examination found that the balloon had no damages.Functional and microscopic inspection were performed, and the balloon was inflated without any problem; however, it was not able to hold pressure due to a pinhole in the balloon, a failure to inflate.The pinhole was located approximately 35 mm from the tip.Media inspection was performed, the photo attached showing the device but is not possible to observe any damage.No other problems with the device were noted.With all the available information, boston scientific concludes the reported event of balloon burst was not confirmed.The analysis on the returned device found that the balloon had a pinhole located approximately at 35 mm from the tip of the device.It is possible that the pinhole found in the balloon occurred due to factors encountered during the procedure or it can be due to excess pressure.Also, it is possible that interaction with any kind of a sharp surface during or previous to the procedure could create friction on the balloon and could have caused the pinhole found on the balloon.These factors and interactions could influence the damage found in the balloon.Therefore, the most probable root cause is adverse event related to procedure.

• Brand Name: CRE WIREGUIDED
• Common Device Name: COLONOSCOPE AND ACCESSORIES, FLEXIBLE/RIGID
• 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 Key: 24133727
• Report Number: 3005099803-2026-00268
• Device Sequence Number: 10343898
• Product Code: FDF
• UDI-Device Identifier: 08714729339335
• UDI-Public: (01)08714729339335(17)280222(10)36133493
• Combination Product (Y/N): N
• Initial Reporter Country: CH
• PMA/510(K) Number: K110833
• Number of Events Summarized: 1
• 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): 02/16/2026

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 Number: M00558400
• Device Catalogue Number: M00558400
• Device Lot Number: 0036133493
• 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 Manufacturer: 01/22/2026
• Initial Report FDA Received Date: 01/21/2026
• Supplement Report FDA Received Date: 02/16/2026
• Was Device Evaluated by Manufacturer? (Y/N): Yes
• Date Device Manufactured: 03/24/2025
• 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 Age: 65 YR
• Patient Sex: Female
• Patient Weight: 63 KG