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U.S. Department of Health and Human Services

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

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BOSTON SCIENTIFIC CORPORATION REZUM; UNIT, ELECTROSURGICAL ENDOSCOPIC (WITH OR WITHOUT ACCESSORIES) Back to Search Results
Model Number M006D2201-003
Medical Device Problem Code Retraction Problem (1536)
Health Effect - Clinical Code Discomfort (2330)
Date of Event 03/06/2026
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that, during the water vapor thermal therapy procedure, the needle failed to retract.It was noted that the patient was showing a little discomfort during the procedure, so the physician decided to finish the procedure.The physician was able to remove the delivery device by pulling the needle safety pin and manually retracting the needle.There were no further patient complications.This event is being reported for an aborted/cancelled procedure with a patient under anesthesia or sedation status is unknown.
 
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Brand Name
REZUM
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
4100 hamline avenue north
saint paul MN 55112 5798
Manufacturer Contact
farshad fahimi
4100 hamline avenue north
building c
saint paul, MN 55112
MDR Report Key24783593
Report Number2124215-2026-18399
Device Sequence Number6133534
Product Code KNS
UDI-Device Identifier08714729992547
UDI-Public(01)08714729992547(17)271007(10)38108674
Combination Product (Y/N)N
PMA/510(K) Number
K191505
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
Initial Reporter Occupation Physician
Type of Report Initial,Followup
Report Date (Section B) 05/08/2026
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 NumberM006D2201-003
Device Catalogue NumberM006D2201-003
Device Lot Number0038108674
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer03/24/2026
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 03/06/2026
Supplement Date Received by Manufacturer04/08/2026
Initial Report FDA Received Date04/03/2026
Supplement Report FDA Received Date05/08/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured10/17/2025
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 SexMale
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