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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BOSTON SCIENTIFIC CORPORATION CRE PRO; Catheter, Biliary, Diagnostic

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BOSTON SCIENTIFIC CORPORATION CRE PRO; Catheter, Biliary, Diagnostic Back to Search Results
Model Number M00558650
Medical Device Problem Codes Inflation Problem (1310); Leak/Splash (1354)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 08/31/2026
Type of Reportable Event Malfunction
Event or Problem Description
It was reported to boston scientific corporation that a cre pro wireguided dilatation balloon was attempted to be used during a procedure performed on (b)(6) 2026.During the procedure, it was reported that the customer was unable to inflate the balloon as there was fluid coming out and was leaking.The procedure was completed with another of the same device.The anatomy location of the procedure is unknown and is being reported as the balloon leak may have occurred in the esophagus.There were no patient complications reported as a result of this event and patient's condition at the conclusion of the procedure was reported to be stable.
 
Additional Manufacturer Narrative
Block h6: imdrf device code a0504 captures the reportable event of balloon leak in an unknown anatomy location.
 
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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 Key50855057
Report Number3005099803-2026-03901
Device Sequence Number10053659
Product Code FGE
UDI-Device Identifier08714729797531
UDI-Public(01)08714729797531(17)290225(10)38701754
Combination Product (Y/N)N
Initial Reporter CountryGM
PMA/510(K) Number
K112994
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source Other,Foreign,Health Professional,Company Representative
Initial Reporter Occupation Nurse
Type of Report Initial
Report Date (Section B) 09/22/2026
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 NumberM00558650
Device Catalogue NumberM00558650
Device Lot Number0038701754
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 08/31/2026
Initial Report FDA Received Date09/22/2026
Date Device Manufactured02/26/2026
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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