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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BOSTON SCIENTIFIC CORPORATION Speedband Superview Super 7; Ligator, Esophageal

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BOSTON SCIENTIFIC CORPORATION Speedband Superview Super 7; Ligator, Esophageal Back to Search Results
Model Number M00542251
Medical Device Problem Code Failure to Fire (2610)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 08/27/2026
Type of Reportable Event Malfunction
Event or Problem Description
It was reported to boston scientific corporation that a band ligation was used in an unknown location for an esophageal varices treatment via gastroscopy procedure performed on (b)(6) 2026.During the procedure the bands were stuck together, and it could not be deployed normally.The procedure was completed with another of the same device.There were no patient complications reported as a result of this event.The patient condition is stable after the procedure.
 
Additional Manufacturer Narrative
Block h6: imdrf device code a050501 captures the reportable event of bands failure to deploy.Device evaluation.The device was not returned for analysis; therefore, a technical analysis could not be performed.A device media analysis was performed.During the media inspection of the video attached it was possible to observe that the bands were not able to deploy.A device history record review was completed.It was confirmed this device met manufacturing specifications prior to distribution and there were no manufacturing deviations which could have contributed to the reported event.A similar complaint review was completed.There were no emerging trends identified that warrant further action.Based on the event description, information and media provided by the customer there is not enough evidence to determine whether the issue was induced by the physician technique during the procedure or it was related to a device malfunction, " cause not established" is selected as the most probable cause for this event.All compiled information on this investigation determines that the most probable cause is "cause not established".
 
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Brand Name
Speedband Superview Super 7
Common Device Name
Ligator, Esophageal
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 Key50842168
Report Number3005099803-2026-03884
Device Sequence Number16019879
Product Code MND
UDI-Device Identifier08714729201960
Combination Product (Y/N)N
Initial Reporter CountryCH
PMA/510(K) Number
Exempt
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source Other,Foreign,Health Professional,Company Representative
Initial Reporter Occupation Physician
Type of Report Initial
Report Date (Section B) 09/21/2026
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 NumberM00542251
Device Catalogue NumberM00542251
Device Lot Number0038774646
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 08/28/2026
Initial Report FDA Received Date09/21/2026
Date Device Manufactured03/03/2026
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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