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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BOSTON SCIENTIFIC CORPORATION COYOTE?; CATHETER, PERCUTANEOUS

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BOSTON SCIENTIFIC CORPORATION COYOTE?; CATHETER, PERCUTANEOUS Back to Search Results
Model Number H74939185252210
Medical Device Problem Code Material Rupture (1546)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 01/27/2026
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that balloon rupture occurred.The 99% stenosed target lesion was located in the moderately tortuous and severely calcified below the knee vessel.A 2.5mm x 220mm x 150cm coyote balloon catheter was advanced for dilatation.During the procedure, the balloon ruptured after the first inflation at 10 atmospheres for 5 seconds.The device was removed without any problem, and the procedure was completed with different device.There were no patient complications as a result of this event.
 
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Brand Name
COYOTE?
Common Device Name
CATHETER, PERCUTANEOUS
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
rachel shields
4100 hamline ave n
arden hills, MN 55112
6512422111
MDR Report Key24406209
Report Number2124215-2026-09695
Device Sequence Number8224222
Product Code LIT
UDI-Device Identifier08714729796893
UDI-Public(01)08714729796893(17)260130(10)30954523
Combination Product (Y/N)N
Initial Reporter CountryJA
PMA/510(K) Number
K162350
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
Report Date (Section B) 02/20/2026
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 Expiration Date01/30/2026
Device Model NumberH74939185252210
Device Catalogue NumberH74939185252210
Device Lot Number0030954523
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 01/27/2026
Initial Report FDA Received Date02/20/2026
Date Device Manufactured01/31/2023
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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