| 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
|
|
+1(914)571-6918
|
|
| MDR Report Key | 25850269 |
| Report Number | 3005099803-2026-02889 |
| Device Sequence Number | 12145616 |
| Product Code |
FGE
|
| UDI-Device Identifier | 08714729797562 |
| UDI-Public | (01)08714729797562(17)280529(10)36644875 |
| Combination Product (Y/N) | N |
| Initial Reporter State | MA |
| Initial Reporter Country | US |
| PMA/510(K) Number | K112994 |
| Number of Events Summarized | 1 |
| Summary Report (Y/N) | N |
| Reporter Type |
Manufacturer
|
| Report Source |
Other,Foreign,Company Representative |
| Initial Reporter Occupation |
Non-Healthcare Professional
|
| Type of Report
| Initial,Followup |
| Report Date (Section B) |
08/13/2026 |
| 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 Number | M00558680 |
| Device Catalogue Number | M00558680 |
| Device Lot Number | 0036644875 |
| Was Device Available for Evaluation? |
No
|
| Is the Reporter a Health Professional? |
No
|
| Was the Report Sent to FDA? |
No
|
| Type of Report(Section G) | Thirty-Day |
| Initial Date Received by Manufacturer | 06/23/2026 |
| Supplement Date Received by Manufacturer | 07/24/2026
|
| Initial Report FDA Received Date | 07/16/2026 |
| Supplement Report FDA Received Date | 08/14/2026
|
| Date Device Manufactured | 05/30/2025 |
| 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 Number | 1 |
| Patient Sex | Unknown |