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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 H74939135152010
Medical Device Problem Code Material Rupture (1546)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 01/13/2026
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that a balloon rupture occurred.The 100% stenosed target lesion was located in the mildly tortuous and mildly calcified superficial femoral artery.A 1.5mm x 20mm x 143cm coyote es mr balloon catheter was advanced for dilation.During the procedure, the balloon ruptured upon first inflation at 6 atmospheres for 30 seconds.The device was removed without any problem, and the procedure was completed with another of the same device.There were no patient complications as a result of this event.
 
Additional Manufacturer Narrative
Investigation results: device evaluated by mfr: the coyote device was returned to 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.Microscopic examination revealed that the balloon ruptured along the proximal marker band area.Inspection of the remainder of the device presented no other damage or irregularities.Product analysis confirmed the reported complaint.This concludes the product analysis.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 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 a balloon rupture occurred.The 100% stenosed target lesion was located in the mildly tortuous and mildly calcified superficial femoral artery.A 1.5mm x 20mm x 143cm coyote es mr balloon catheter was advanced for dilation.During the procedure, the balloon ruptured upon first inflation at 6 atmospheres for 30 seconds.The device was removed without any problem, and the procedure was completed with another of the same 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 Key24284361
Report Number2124215-2026-07026
Device Sequence Number15533477
Product Code LIT
UDI-Device Identifier08714729767169
UDI-Public(01)08714729767169(17)271017(10)35084970
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) 04/08/2026
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 NumberH74939135152010
Device Catalogue NumberH74939135152010
Device Lot Number0035084970
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer02/02/2026
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 01/13/2026
Supplement Date Received by Manufacturer03/20/2026
Initial Report FDA Received Date02/06/2026
Supplement Report FDA Received Date04/08/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured10/17/2024
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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