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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BOSTON SCIENTIFIC CORPORATION TRUEtome Jag 44; Unit, Electrosurgical, Endoscopic (With Or Without Accessories)

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BOSTON SCIENTIFIC CORPORATION TRUEtome Jag 44; Unit, Electrosurgical, Endoscopic (With Or Without Accessories) Back to Search Results
Model Number M00583100
Medical Device Problem Codes Break (1069); Deformation Due to Compressive Stress (2889); Material Integrity Problem (2978)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 08/17/2026
Type of Reportable Event Malfunction
Event or Problem Description
It was reported to boston scientific corporation that a truetome jag 44 was being prepared for used in the duodenal papilla during an endoscopic retrograde cholangiopancreatography (ercp) procedure to treat common bile duct stone to be performed on (b)(6)2026.During preparation, when the package was unpacked, it was found that the tip of the tome was split.Additionally, a photo of the complaint device was provided and showed that the cutting wire was broken and kinked.The procedure was completed with another of the same device.There was no patient complications reported as a result of this event.The patient's condition at the conclusion of the procedure was reported to be stable.
 
Additional Manufacturer Narrative
Block h6: imdrf device code a0401 captures the reportable event of cutting wire break.Imdrf device code a040601 captures the reportable event of cutting wire kinked.
 
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Brand Name
TRUEtome Jag 44
Common Device Name
Unit, Electrosurgical, Endoscopic (With Or Without Accessories)
Manufacturer (Section D)
BOSTON SCIENTIFIC CORPORATION
300 boston scientific way
marlborough MA 01752
Manufacturer (Section G)
Boston Scientific Corporation
2546 calle primera
alajuela
CS  
Manufacturer Contact
christina lam
300 boston scientific way
marlborough, MA 01752
+1(914)571-6918
MDR Report Key50721272
Report Number3005099803-2026-03711
Device Sequence Number8450659
Product Code KNS
UDI-Device Identifier08714729858645
Combination Product (Y/N)N
Initial Reporter CountryCH
PMA/510(K) Number
K122203
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source Other,Foreign,Health Professional,Company Representative,Distributor
Initial Reporter Occupation Physician
Type of Report Initial
Report Date (Section B) 09/10/2026
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 NumberM00583100
Device Catalogue NumberM00583100
Device Lot Number0035666602
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 08/18/2026
Initial Report FDA Received Date09/10/2026
Date Device Manufactured01/20/2025
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 Age46 YR
Patient SexMale
Patient Weight136 LB
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