| Brand Name | HEDGEHOG |
| Common Device Name | ACCESSORIES, CLEANING BRUSHES, FOR ENDOSCOPE |
| Manufacturer (Section D) |
| BOSTON SCIENTIFIC CORPORATION |
| 300 boston scientific way |
| marlborough MA 01752 |
|
| Manufacturer (Section G) |
| CHANGZHOU TEMEIRUI MEDICAL |
| building 34 no 249 |
| 249 middle liangchan |
| changzhou, 100 21320 0 |
|
CH
213200
|
|
| Manufacturer Contact |
|
christina
lam
|
| 300 boston scientific way |
| marlborough, MA 01752
|
|
9145716918
|
|
| MDR Report Key | 24844610 |
| Report Number | 3005099803-2026-01307 |
| Device Sequence Number | 8825573 |
| Product Code |
MNL
|
| UDI-Device Identifier | 00816849010083 |
| UDI-Public | (01)00816849010083(11)250801(10)250730 |
| Combination Product (Y/N) | N |
| Initial Reporter State | MA |
| Initial Reporter Country | JA |
| PMA/510(K) Number | EXEMPT |
| Number of Events Summarized | 1 |
| Summary Report (Y/N) | N |
| Serviced by Third Party (Y/N) | Unknown |
| Reporter Type |
Manufacturer
|
| Report Source |
Other,Foreign,Company Representative,Distributor |
| Initial Reporter Occupation |
Non-Healthcare Professional
|
| Type of Report
| Initial,Followup |
| Report Date (Section B) |
07/21/2026 |
| 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 | 60252 |
| Device Catalogue Number | 60252 |
| Device Lot Number | 0000250730 |
| Was Device Available for Evaluation? |
Device Returned to Manufacturer
|
| Type of Report(Section G) | Thirty-Day |
| Initial Date Received by Manufacturer | 03/13/2026 |
| Supplement Date Received by Manufacturer | 06/25/2026
|
| Initial Report FDA Received Date | 04/10/2026 |
| Supplement Report FDA Received Date | 07/21/2026
|
| Was Device Evaluated by Manufacturer? (Y/N) |
Yes
|
| Date Device Manufactured | 08/01/2025 |
| Is the Device Labeled for Single Use? (Y/N) |
Yes
|
| Usage of Device |
Initial
|
| Patient Sequence Number | 1 |
| Patient Sex | Unknown |