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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 Break (1069)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 09/04/2026
Type of Reportable Event Malfunction
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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 Key50874847
Report Number3005099803-2026-03924
Device Sequence Number13067275
Product Code MND
UDI-Device Identifier08714729201960
UDI-Public(01)08714729201960(17)261002(10)37630331
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) 09/23/2026
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 Expiration Date10/02/2026
Device Model NumberM00542251
Device Catalogue NumberM00542251
Device Lot Number0037630331
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 09/04/2026
Initial Report FDA Received Date09/23/2026
Date Device Manufactured10/02/2025
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 Age45 YR
Patient SexMale
Patient Weight158 LB
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