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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BOSTON SCIENTIFIC CORPORATION SYNERGY? XD; CORONARY DRUG-ELUTING STENT

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BOSTON SCIENTIFIC CORPORATION SYNERGY? XD; CORONARY DRUG-ELUTING STENT Back to Search Results
Model Number H7493941848400
Medical Device Problem Codes Device Dislodged or Dislocated (2923); Material Deformation (2976)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 01/14/2026
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that stent move on balloon occurred.The patient presented with coronary artery disease and underwent percutaneous coronary intervention.A 4.00 x 48mm synergy xd drug-eluting stent (des) was selected for use.However, when the package was opened and removed the device from the hoop, the stent was already accordioned off of the balloon.A new 4.00 x 48mm synergy xd des was then used to complete the procedure.There were no patient complications and the patient fully recovered.
 
Additional Manufacturer Narrative
Good faith effort attempts were made to try and retrieve additional details regarding the reported event, but further information was unable to be obtained.
 
Event or Problem Description
It was reported that stent move on balloon occurred.The patient presented with coronary artery disease and underwent percutaneous coronary intervention.A 4.00 x 48mm synergy xd drug-eluting stent (des) was selected for use.However, when the package was opened and removed the device from the hoop, the stent was already accordioned off of the balloon.A new 4.00 x 48mm synergy xd des was then used to complete the procedure.There were no patient complications and the patient fully recovered.
 
Additional Manufacturer Narrative
Good faith effort attempts were made to try and retrieve additional details regarding the reported event, but further information was unable to be obtained.
 
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Brand Name
SYNERGY? XD
Common Device Name
CORONARY DRUG-ELUTING STENT
Manufacturer (Section D)
BOSTON SCIENTIFIC CORPORATION
300 boston scientific way
marlborough MA 01752
Manufacturer (Section G)
BOSTON SCIENTIFIC CORPORATION
ballybrit business park
galway
EI  
Manufacturer Contact
mark mischke
4100 hamline ave n
arden hills, MN 55112
7634941632
MDR Report Key24292083
Report Number2124215-2026-07109
Device Sequence Number18474696
Product Code NIQ
UDI-Device Identifier08714729985242
UDI-Public(01)08714729985242(17)270811(10)37217408
Combination Product (Y/N)Y
Initial Reporter StateCA
Initial Reporter CountryUS
PMA/510(K) Number
P150003
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)Unknown
Reporter Type Manufacturer
Report Source Health Professional,Company Representative
Initial Reporter Occupation Other Health Care Professional
Type of Report Initial,Followup
Report Date (Section B) 03/06/2026
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 NumberH7493941848400
Device Catalogue NumberH7493941848400
Device Lot Number0037217408
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 01/15/2026
Supplement Date Received by Manufacturer02/10/2026
Initial Report FDA Received Date02/09/2026
Supplement Report FDA Received Date03/06/2026
Date Device Manufactured08/11/2025
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
Patient SexUnknown
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