MAUDE Adverse Event Report: BOSTON SCIENTIFIC CORPORATION AUTOTOME RX 39; UNIT, ELECTROSURGICAL, ENDOSCOPIC (WITH OR WITHOUT ACCESSORIES)

Model Number	M00545200
Medical Device Problem Codes	Break (1069); Deformation Due to Compressive Stress (2889); Adverse Event Without Identified Device or Use Problem (2993)
Health Effect - Clinical Code	No Clinical Signs, Symptoms or Conditions (4582)
Date of Event	01/01/2026
Type of Reportable Event	Malfunction
Additional Manufacturer Narrative
Block b3: approximated based on the date the manufacturer became aware of the event.Block h6: imdrf device code a040601 captures the reportable event of cutting wire kinked and cutting wire anchor dislodged or dislocated.
Event or Problem Description
It was reported to boston scientific corporation that an autotome rx 39 was attempted to be used during an endoscopic retrograde cholangiopancreatography (ercp) procedure to treat stones performed on an unknown date.During the procedure, the wire anchor was dislodged from the catheter upon sphincterotomy.It was reported that the cutting wire was intact, and no part of the device was detached and fell inside the patient.The procedure was completed with another of the same device.There were no patient complications as a result of this event and the patient's condition was reported to be fully recovered.
Event or Problem Description
It was reported to boston scientific corporation that an autotome rx 39 was attempted to be used during an endoscopic retrograde cholangiopancreatography (ercp) procedure to treat stones performed on an unknown date.During the procedure, the wire anchor was dislodged from the catheter upon sphincterotomy.It was reported that the cutting wire was intact, and no part of the device was detached and fell inside the patient.The procedure was completed with another of the same device.There were no patient complications as a result of this event and the patient's condition was reported to be fully recovered.Additional information was received on february 12, 2026: it was reported that there was a break in the cutting wire.The anatomy location was the ampulla.
Additional Manufacturer Narrative
Block b3: approximated based on the date the manufacturer became aware of the event.Block g2: (additional information) block b5 has been updated based on additional information received february 12, 2026.Block h6: imdrf device code a040601 captures the reportable event of cutting wire kinked and cutting wire anchor dislodged or dislocated.Block h11: investigation results.The returned autotome rx 39 was analyzed, and visual inspection found that the cutting wire was blackened, kinked and broken from the proximal pierce hole.Additionally, the working length was bent.No other problems with the device were noted.A review of the manufacturing documentation for this device revealed that no anomalies or deviations related to the event occurred during manufacturing.A risk review was completed and confirmed that the event of wire break and wire kinked was defined in the risk documentation.This event type has been accounted for during product risk analysis to support acceptable risk benefit for the product.With all the available information, boston scientific concludes the reported event of cutting wire break was confirmed.The results of the analysis performed on the returned device found that the cutting wire was kinked and broken from the proximal pierce hole.It is most likely that procedural or anatomical factors encountered during the use of the device could have affected the device performance and its integrity.The break in the cutting wire could have been generated if there was contact between the device and the scope during energization or if the device exceeded the maximum of voltage during procedure.Also, energizing the device prior to performing sphincterotomy can compromise the cutting wires integrity, causing premature cutting wire fatigue.Once the cutting wire breaks, any attempt to remove the device from the scope can bend the cutting wire as observed in the product analysis.The investigation findings and all information available concludes the most probable root cause is an adverse event related to procedure.

• Brand Name: AUTOTOME RX 39
• Common Device Name: UNIT, ELECTROSURGICAL, ENDOSCOPIC (WITH OR WITHOUT ACCESSORIES)
• Manufacturer (Section D): BOSTON SCIENTIFIC CORPORATION; 300 boston scientific way; marlborough MA 01752
• Manufacturer (Section G): BOSTON SCIENTIFIC CORPORATION; 2546 calle primera; alajuela ; CS
• Manufacturer Contact: christina lam ; 300 boston scientific way; marlborough, MA 01752 ; 9145716918
• MDR Report Key: 24341506
• Report Number: 3005099803-2026-00602
• Device Sequence Number: 8289951
• Product Code: KNS
• UDI-Device Identifier: 08714729444770
• UDI-Public: (01)08714729444770(17)281030(10)37849325
• Combination Product (Y/N): N
• Initial Reporter State: TX
• Initial Reporter Country: US
• PMA/510(K) Number: K013153
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Serviced by Third Party (Y/N): Unknown
• Reporter Type: Manufacturer
• Report Source: Health Professional,Company Representative
• Initial Reporter Occupation: Physician
• 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 Number: M00545200
• Device Catalogue Number: M00545200
• Device Lot Number: 0037849325
• Was Device Available for Evaluation?: Device Returned to Manufacturer
• Date Returned to Manufacturer: 02/04/2026
• Is the Reporter a Health Professional?: Yes
• Type of Report(Section G): Thirty-Day
• Initial Date Received by Manufacturer: 01/20/2026
• Supplement Date Received by Manufacturer: 02/12/2026
• Initial Report FDA Received Date: 02/15/2026
• Supplement Report FDA Received Date: 03/06/2026
• Was Device Evaluated by Manufacturer? (Y/N): Yes
• Date Device Manufactured: 10/31/2025
• 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 Sex: Unknown