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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BOSTON SCIENTIFIC CORPORATION ROTAWIRE? AND WIRECLIP? TORQUER; CATHETER, CORONARY, ATHERECTOMY

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BOSTON SCIENTIFIC CORPORATION ROTAWIRE? AND WIRECLIP? TORQUER; CATHETER, CORONARY, ATHERECTOMY Back to Search Results
Model Number H802228240020
Medical Device Problem Codes Fracture (1260); Difficult to Advance (2920)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 05/01/2026
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
B3 - date of event: date of event was approximated to 05/01/2026 as the exact event date was not reported.Good faith effort attempts were made to try and retrieve additional details regarding the reported event, but further information was unable to be obtained.
 
Event or Problem Description
It was reported that the guidewire broke.A 330cm rotawire-ic was selected for use.During the procedure, it was noted that the guidewire broke upon entering the warhead, making it impossible to move forward.The procedure was then completed using an alternate device, and no patient complications were reported.
 
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Brand Name
ROTAWIRE? AND WIRECLIP? TORQUER
Common Device Name
CATHETER, CORONARY, ATHERECTOMY
Manufacturer (Section D)
BOSTON SCIENTIFIC CORPORATION
300 boston scientific way
marlborough MA 01752
Manufacturer (Section G)
BOSTON SCIENTIFIC CORPORATION
302 parkway, global park
la aurora - heredia
CS  
Manufacturer Contact
mark mischke
4100 hamline ave n
arden hills, MN 55112
7634941632
MDR Report Key25600535
Report Number2124215-2026-33438
Device Sequence Number5357765
Product Code MCX
UDI-Device Identifier08714729185871
UDI-Public(01)08714729185871(17)260705(10)34379098
Combination Product (Y/N)N
Initial Reporter CountryBR
PMA/510(K) Number
P900056
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 Other Health Care Professional
Type of Report Initial,Followup
Report Date (Section B) 07/15/2026
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 Expiration Date07/05/2026
Device Model NumberH802228240020
Device Catalogue NumberH802228240020
Device Lot Number0034379098
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 05/26/2026
Supplement Date Received by Manufacturer06/26/2026
Initial Report FDA Received Date06/23/2026
Supplement Report FDA Received Date07/15/2026
Date Device Manufactured07/05/2024
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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