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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BOSTON SCIENTIFIC CORPORATION DIREXION?; CATHETER, CONTINUOUS FLUSH

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BOSTON SCIENTIFIC CORPORATION DIREXION?; CATHETER, CONTINUOUS FLUSH Back to Search Results
Model Number M001195240
Medical Device Problem Codes Detachment of Device or Device Component (2907); Physical Resistance/Sticking (4012)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 05/18/2026
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that device component detachment occurred.A direxion catheter infusion was selected for use.During the procedure, resistance was encountered while using the device, and a device component detached.The device could not be used as intended and an alternate device was required to continue the procedure.No patient complications were reported as a result of this event.
 
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Brand Name
DIREXION?
Common Device Name
CATHETER, CONTINUOUS FLUSH
Manufacturer (Section D)
BOSTON SCIENTIFIC CORPORATION
300 boston scientific way
marlborough MA 01752
Manufacturer (Section G)
BOSTON SCIENTIFIC CORPORATION
model farm road
cork T12 Y K88
EI   T12 YK88
Manufacturer Contact
ricardo amaro castro
4100 hamline ave n
arden hills, MN 55112
9529306396
MDR Report Key25474182
Report Number2124215-2026-31263
Device Sequence Number18730004
Product Code KRA
UDI-Device Identifier08714729839354
UDI-Public(01)08714729839354(17)280220(10)38649505
Combination Product (Y/N)N
Initial Reporter StateOH
Initial Reporter CountryUS
PMA/510(K) Number
K163701
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) 06/11/2026
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 NumberM001195240
Device Catalogue NumberM001195240
Device Lot Number0038649505
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 05/18/2026
Initial Report FDA Received Date06/11/2026
Date Device Manufactured02/20/2026
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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