• Decrease font size
  • Return font size to normal
  • Increase font size
U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BOSTON SCIENTIFIC CORPORATION AGENT?; DRUG-ELUTING PERCUTANEOUS TRANSLUMINAL CORONARY ANGIOPLASTY CATHETER

  • Print
  • Share
  • E-mail
-
Super Search Devices@FDA
510(k) | DeNovo | Registration & Listing | Adverse Events | Recalls | PMA | HDE | Classification | Standards
CFR Title 21 | Radiation-Emitting Products | X-Ray Assembler | Medsun Reports | CLIA | TPLC
 

BOSTON SCIENTIFIC CORPORATION AGENT?; DRUG-ELUTING PERCUTANEOUS TRANSLUMINAL CORONARY ANGIOPLASTY CATHETER Back to Search Results
Model Number H7493960820300
Medical Device Problem Codes Nonstandard Device (1420); Failure to Advance (2524)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 02/05/2026
Type of Reportable Event Malfunction
Event or Problem Description
Reportable based on device analysis completed on 26march2026.It was reported that the device was unable to cross.The patient presented with in-stent restenosis (isr) for a percutaneous coronary intervention (pci).A 3.00 mm x 20.00 mm agent drug-coated balloon (dcb) was selected for use.Following pre-treatment with balloon angioplasty and confirmed with intravascular ultrasound, the agent dcb was inserted but was unable to cross the target lesion.The device was removed and the procedure was completed with a another of the same device.There were no patient complications, and the patient fully recovered.However, the return device analysis revealed a tear was noted to the outer shaft polymer extrusion.
 
Additional Manufacturer Narrative
Investigation results: device analysis findings: the device was not returned for analysis; therefore, a technical analysis could not be performed.Device history record (dhr) review: it was confirmed that this device met manufacturing specification prior to distribution and there no manufacturing deviations which could have contributed to the reported event.Labeling review: review of the instructions for use (ifu) confirmed there was relevant content and sufficient guidance with respect to the circumstances described within this complaint.No updates are required to the ifu as a result of this event.Risk review: a risk review was performed, and it confirmed that the event was defined in the risk documentation and is recorded accordingly in the product record review (prr) table.This event type has been accounted for during product risk analysis to support acceptable risk benefit for the product.Investigation conclusion: this investigation is assigned a most probable investigation conclusion code of cause not established.This code was selected as the most probable complaint cause based on the information available and the investigation conducted.It is not possible to test the device for navigation through patient anatomy during analysis.The unreported shaft polymer extrusion tear was most likely caused due to unintentional interaction between the user and the device, at which stage of the procedure/packaging it occurred cannot be established.
 
Search Alerts/Recalls

  New Search  |  Submit an Adverse Event Report

Brand Name
AGENT?
Common Device Name
DRUG-ELUTING PERCUTANEOUS TRANSLUMINAL CORONARY ANGIOPLASTY CATHETER
Manufacturer (Section D)
BOSTON SCIENTIFIC CORPORATION
300 boston scientific way
marlborough MA 01752
Manufacturer (Section G)
FREUDENBERG MEDICAL
adenauerstrasse 15
wuerselen 52146
GM   52146
Manufacturer Contact
mark mischke
4100 hamline ave n
arden hills, MN 55112
7634941632
MDR Report Key24913672
Report Number2124215-2026-21012
Device Sequence Number13244013
Product Code OOB
UDI-Device Identifier00191506014827
UDI-Public(01)00191506014827(17)260806(10)7989H24
Combination Product (Y/N)Y
Initial Reporter StateTX
Initial Reporter CountryUS
PMA/510(K) Number
P230035
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 Physician
Type of Report Initial
Report Date (Section B) 04/17/2026
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 Date08/06/2026
Device Model NumberH7493960820300
Device Catalogue NumberH7493960820300
Device Lot Number07989H24
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer02/24/2026
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 03/26/2026
Initial Report FDA Received Date04/17/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured08/06/2024
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
-
-