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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 M001195300
Medical Device Problem Code Detachment of Device or Device Component (2907)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 07/31/2026
Type of Reportable Event Malfunction
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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
business and technology park,
cork T12 Y K88
EI   T12 YK88
Manufacturer Contact
ricardo amaro castro
4100 hamline ave n
arden hills, MN 55112
+1(952)930-6396
MDR Report Key50508438
Report Number2124215-2026-46122
Device Sequence Number13314900
Product Code KRA
UDI-Device Identifier08714729839415
UDI-Public(01)08714729839415(17)280603(10)40493440
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
Reporter Type Manufacturer
Report Source Health Professional,Company Representative
Initial Reporter Occupation Physician
Type of Report Initial,Followup
Report Date (Section B) 09/23/2026
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 NumberM001195300
Device Catalogue NumberM001195300
Device Lot Number0040493440
Was Device Available for Evaluation? Yes
Date Returned to Manufacturer09/08/2026
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 07/31/2026
Supplement Date Received by Manufacturer08/31/2026
Initial Report FDA Received Date08/28/2026
Supplement Report FDA Received Date09/23/2026
Was Device Evaluated by Manufacturer? (Y/N) No
Date Device Manufactured06/04/2026
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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