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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BOSTON SCIENTIFIC CORPORATION CRE PRO; CATHETER, BILIARY, DIAGNOSTIC

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BOSTON SCIENTIFIC CORPORATION CRE PRO; CATHETER, BILIARY, DIAGNOSTIC Back to Search Results
Model Number M00558710
Medical Device Problem Codes Burst Container or Vessel (1074); Inflation Problem (1310)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 03/30/2026
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
Block h6: imdrf device code a0402 captures the reportable event of a balloon burst.
 
Event or Problem Description
It was reported to boston scientific corporation that a cre pro wireguided dilatation balloon was attempted to be used in the esophagus during a dilation procedure to treat stricture performed on (b)(6) 2026.During the procedure, when the balloon was inflated, the staff heard a popped sound, and the balloon did not stay inflated.It was reported that no piece of the balloon detached inside the patient.The procedure was completed using another cre pro wireguided dilatation balloon.There were no patient complications reported as a result of this event and the patient's condition at the conclusion of the procedure is fine.
 
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Brand Name
CRE PRO
Common Device Name
CATHETER, BILIARY, DIAGNOSTIC
Manufacturer (Section D)
BOSTON SCIENTIFIC CORPORATION
300 boston scientific way
marlborough MA 01752
Manufacturer (Section G)
BOSTON SCIENTIFIC CORK LIMITED
cork business technology park
model farm road
cork T12 Y K88
EI   T12 YK88
Manufacturer Contact
christina lam
300 boston scientific way
marlborough, MA 01752
9145716918
MDR Report Key25342786
Report Number3005099803-2026-02222
Device Sequence Number17452812
Product Code FGE
UDI-Device Identifier08714729797593
UDI-Public(01)08714729797593(17)280616(10)36775386
Combination Product (Y/N)N
Initial Reporter CountryCA
PMA/510(K) Number
K112994
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 Non-Healthcare Professional
Type of Report Initial,Followup
Report Date (Section B) 06/29/2026
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 NumberM00558710
Device Catalogue NumberM00558710
Device Lot Number0036775386
Was Device Available for Evaluation? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 05/07/2026
Supplement Date Received by Manufacturer06/05/2026
Initial Report FDA Received Date05/31/2026
Supplement Report FDA Received Date06/29/2026
Date Device Manufactured06/17/2025
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 SexUnknown
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