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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BOSTON SCIENTIFIC CORPORATION SPYGLASS? DISCOVER; CHOLEDOCHOSCOPE AND ACCESSORIES, FLEXIBLE/RIGID

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BOSTON SCIENTIFIC CORPORATION SPYGLASS? DISCOVER; CHOLEDOCHOSCOPE AND ACCESSORIES, FLEXIBLE/RIGID Back to Search Results
Model Number M00546780
Medical Device Problem Code Optical Problem (3001)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 04/09/2026
Type of Reportable Event Malfunction
Event or Problem Description
It was reported to boston scientific corporation that a spy discover catheter was attempted for use in the common bile duct during a common bile duct exploration procedure on (b)(6) 2026, for the treatment of biliary obstruction.During the procedure, the scope stopped working in the middle of the case and gray dots appeared on the screen.The procedure was not completed due to this event.No patient complications were reported as a result of this event.
 
Additional Manufacturer Narrative
Block h6 (impact codes): imdrf impact code f1001 is being used to capture the reportable event of absence of treatment.
 
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Brand Name
SPYGLASS? DISCOVER
Common Device Name
CHOLEDOCHOSCOPE AND ACCESSORIES, FLEXIBLE/RIGID
Manufacturer (Section D)
BOSTON SCIENTIFIC CORPORATION
300 boston scientific way
marlborough MA 01752
Manufacturer (Section G)
BOSTON SCIENTIFIC CORPORATION
cashel road
clonmel
EI  
Manufacturer Contact
christina lam
300 boston scientific way
marlborough, MA 01752
9145716918
MDR Report Key25112256
Report Number3005099803-2026-01669
Device Sequence Number9321886
Product Code FBN
UDI-Device Identifier08714729994183
UDI-Public(01)08714729994183(17)280109(10)40421555
Combination Product (Y/N)N
Initial Reporter StateGA
Initial Reporter CountryUS
PMA/510(K) Number
K200483
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,Followup,Followup
Report Date (Section B) 07/09/2026
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 NumberM00546780
Device Catalogue NumberM00546780
Device Lot Number0040421555
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 04/09/2026
Supplement Date Received by Manufacturer05/04/2026
06/12/2026
Initial Report FDA Received Date05/07/2026
Supplement Report FDA Received Date06/02/2026
07/09/2026
Date Device Manufactured01/09/2026
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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