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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BOSTON SCIENTIFIC CORPORATION AUTOTOME RX 44; UNIT, ELECTROSURGICAL, ENDOSCOPIC (WITH OR WITHOUT ACCESSORIES)

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BOSTON SCIENTIFIC CORPORATION AUTOTOME RX 44; UNIT, ELECTROSURGICAL, ENDOSCOPIC (WITH OR WITHOUT ACCESSORIES) Back to Search Results
Model Number M00545170
Medical Device Problem Codes Deformation Due to Compressive Stress (2889); Difficult to Advance (2920)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 04/01/2026
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
Block b3: approximated based on the date the manufacturer became aware of the event.Block h6: imdrf device code a040601 captures the reportable event of wire/anchor dislodged or dislocated.
 
Event or Problem Description
It was reported to boston scientific corporation that an autotome rx 44 was used during a sphincterotomy procedure performed on an unknown date.During the procedure, the device does not allow the guidewire to slide.Also, the distal tip does not bend correctly and loses its shape memory.During sphincterotomy, the cutting wire detached from the catheter.The procedure was not completed due to this event.There were no reported patient complications as a result of this event.
 
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Brand Name
AUTOTOME RX 44
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
2546 calle primera
alajuela
CS  
Manufacturer Contact
christina lam
300 boston scientific way
marlborough, MA 01752
9145716918
MDR Report Key25263555
Report Number3005099803-2026-02053
Device Sequence Number9758966
Product Code KNS
UDI-Device Identifier08714729444749
UDI-Public(01)08714729444749(17)290106(10)38287980
Combination Product (Y/N)N
Initial Reporter CountryIT
PMA/510(K) Number
K013153
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
Initial Reporter Occupation Physician
Type of Report Initial,Followup
Report Date (Section B) 06/22/2026
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 NumberM00545170
Device Catalogue NumberM00545170
Device Lot Number0038287980
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 04/29/2026
Supplement Date Received by Manufacturer06/02/2026
Initial Report FDA Received Date05/23/2026
Supplement Report FDA Received Date06/22/2026
Date Device Manufactured01/07/2026
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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