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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BOSTON SCIENTIFIC CORPORATION FLEXIMA? BILIARY; CATHETER, BILIARY, DIAGNOSTIC

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BOSTON SCIENTIFIC CORPORATION FLEXIMA? BILIARY; CATHETER, BILIARY, DIAGNOSTIC Back to Search Results
Model Number M00539260
Medical Device Problem Codes Break (1069); Positioning Failure (1158)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 05/19/2026
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
Block e1: (initial reporter facility name) - the reported health care facility is (b)(6) hospital (b)(6) ((b)(6) hospital (b)(6).Block h6: imdrf device code a0401 captures the reportable event of stent break.
 
Event or Problem Description
It was reported to boston scientific corporation that a flexima biliary stent was intended to be implanted in the common bile duct to treat a stenosis during an endoscopic retrograde cholangiopancreatography (ercp) procedure with stent placement, performed on (b)(6) 2026.During the procedure, the stent was fractured and could not be deployed.The procedure was completed with another of the same device.There were no patient complications reported as a results of this event and the patient's condition at the conclusion of the procedure was reported to be stable.
 
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Brand Name
FLEXIMA? BILIARY
Common Device Name
CATHETER, BILIARY, DIAGNOSTIC
Manufacturer (Section D)
BOSTON SCIENTIFIC CORPORATION
300 boston scientific way
marlborough MA 01752
Manufacturer (Section G)
BOSTON SCIENTIFIC CORPORATION
780 brookside drive
spencer IN 47460
Manufacturer Contact
christina lam
300 boston scientific way
marlborough, MA 01752
9145716918
MDR Report Key25460994
Report Number3005099803-2026-02403
Device Sequence Number10410154
Product Code FGE
UDI-Device Identifier08714729162575
UDI-Public(01)08714729162575(17)280812(10)37199765
Combination Product (Y/N)N
Initial Reporter CountryCH
PMA/510(K) Number
K965147
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,Distributor
Initial Reporter Occupation Physician
Type of Report Initial,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 NumberM00539260
Device Catalogue NumberM00539260
Device Lot Number0037199765
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 05/20/2026
Supplement Date Received by Manufacturer06/17/2026
Initial Report FDA Received Date06/10/2026
Supplement Report FDA Received Date07/09/2026
Date Device Manufactured08/13/2025
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 Age68 YR
Patient SexMale
Patient Weight74 KG
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