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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 H74939135204010
Medical Device Problem Code Material Rupture (1546)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 01/15/2026
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
E1 - initial reporter address 1: (b)(6).
 
Event or Problem Description
It was reported that balloon rupture occurred.The 90% stenosed target lesion was located in the moderately tortuous and moderately calcified vessel below the knee.A 2mm x 40mm x 145cm coyote es balloon was advanced for dilation.However, during the second inflation at 14 atmospheres for 60 seconds, the balloon ruptured.The device was removed and the procedure was completed with a different device.There were no patient complications as a result of this event, and the patient was in good condition post-procedure.
 
Additional Manufacturer Narrative
E1 - initial reporter address 1: (b)(6).Device analysis findings: upon receipt at 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 pinhole 25mm from the tip.Inspection of the remainder of the device presented no other damage or irregularities.Product analysis confirmed there is a pinhole in the balloon.Device history record: it was confirmed this device met manufacturing specification prior to distribution and there were no manufacturing deviations which could have contributed to the reported event.Labeling review: 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.Investigation conclusion: based on a thorough review of the reported complaint, boston scientific has assigned an investigation conclusion code of adverse event related to patient condition.
 
Event or Problem Description
It was reported that balloon rupture occurred.The 90% stenosed target lesion was located in the moderately tortuous and moderately calcified vessel below the knee.A 2mm x 40mm x 145cm coyote es balloon was advanced for dilation.However, during the second inflation at 14 atmospheres for 60 seconds, the balloon ruptured.The device was removed and the procedure was completed with a different device.There were no patient complications as a result of this event, and the patient was in good condition post-procedure.
 
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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 Key24176344
Report Number2124215-2026-04378
Device Sequence Number9979769
Product Code LIT
UDI-Device Identifier08714729767190
UDI-Public(01)08714729767190(17)270812(10)34624396
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) 04/15/2026
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 Model NumberH74939135204010
Device Catalogue NumberH74939135204010
Device Lot Number0034624396
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 01/15/2026
Supplement Date Received by Manufacturer03/31/2026
Initial Report FDA Received Date01/26/2026
Supplement Report FDA Received Date04/15/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured08/12/2024
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
Patient SexUnknown
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