FDA Adverse Event Injury Summary report: N

OPTICROSS 18

MDR report key: 21808008 · Received April 9, 2025

Report

Report Number
2124215-2025-20636
Event Type
Injury
Date Received
April 9, 2025
Date of Event
March 11, 2025
Report Date
June 23, 2025
Manufacturer
BOSTON SCIENTIFIC CORPORATION
Product Code
OBJ
UDI-DI
08714729904366
PMA / PMN Number
K160514
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NY, US
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

G4-PREMARKET / 510(K) #: K160514, K222568. DETAILED PRODUCT INFORMATION WAS NOT PROVIDED TO BSC. WE ARE STILL WAITING TO OBTAIN THE INFORMATION THROUGH GOOD FAITH EFFORT. BECAUSE THE PRODUCT IS UNKNOWN AT THIS TIME, WE ARE UNABLE TO PROVIDE THE COMPLETE UNIQUE IDENTIFIER (UDI) # AND OTHER PRODUCT SPECIFIC INFORMATION. IF ADDITIONAL DETAILS BECOME AVAILABLE, A SUPPLEMENTAL REPORT WILL BE SUBMITTED.

Additional Manufacturer Narrative · 0

CORRECTION REPORT IS BEING FILED TO UPDATE H6 (DEVICE CODES). G4-PREMARKET / 510(K) #: K160514, K222568. DETAILED PRODUCT INFORMATION WAS NOT PROVIDED TO BSC. PER THE SOURCE, THIS INFORMATION WAS NOT AVAILABLE. BECAUSE THE PRODUCT IS UNKNOWN AT THIS TIME, WE ARE UNABLE TO PROVIDE THE COMPLETE UNIQUE IDENTIFIER (UDI) # AND OTHER PRODUCT SPECIFIC INFORMATION. IF ADDITIONAL DETAILS BECOME AVAILABLE, A SUPPLEMENTAL REPORT WILL BE SUBMITTED.

Additional Manufacturer Narrative · 0

DETAILED PRODUCT INFORMATION WAS NOT PROVIDED TO BSC. PER THE SOURCE, THIS INFORMATION WAS NOT AVAILABLE. BECAUSE THE PRODUCT IS UNKNOWN AT THIS TIME, WE ARE UNABLE TO PROVIDE THE COMPLETE UNIQUE IDENTIFIER (UDI) # AND OTHER PRODUCT SPECIFIC INFORMATION. IF ADDITIONAL DETAILS BECOME AVAILABLE, A SUPPLEMENTAL REPORT WILL BE SUBMITTED. THE OPTICROSS 18 WAS NOT RETURNED BUT DEVICE ANALYSIS WAS PERFORMED USING THE PHOTO RECEIVED. THE MEDIA ATTACHED SHOWS THE ISSUES OF CATHETER TWIST AND DETACHMENT.

Additional Manufacturer Narrative · 0

CORRECTION REPORT IS BEING FILED TO UPDATE H6 (IMPACT CODES). G4-PREMARKET / 510(K) #: K160514, K222568 DETAILED PRODUCT INFORMATION WAS NOT PROVIDED TO BSC. PER THE SOURCE, THIS INFORMATION WAS NOT AVAILABLE. BECAUSE THE PRODUCT IS UNKNOWN AT THIS TIME, WE ARE UNABLE TO PROVIDE THE COMPLETE UNIQUE IDENTIFIER (UDI) # AND OTHER PRODUCT SPECIFIC INFORMATION. IF ADDITIONAL DETAILS BECOME AVAILABLE, A SUPPLEMENTAL REPORT WILL BE SUBMITTED.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE CATHETER BECAME TANGLED AND SEPARATED, REQUIRING INTERVENTION. AN OPTICROSS 18 VASCULAR IMAGING CATHETER WAS USED FOR A PERIPHERAL INTERVENTION PROCEDURE FOR ARTERIAL DISEASE. DURING THE PROCEDURE, THE CATHETER TWISTED AROUND ITSELF IN THE BODY AND THEN SEPARATED. THE PROCEDURE WAS NOT COMPLETED, AND THE PATIENT WAS THERE WERE NO PATIENT COMPLICATIONS AS A RESULT OF THIS EVENT.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE CATHETER BECAME TANGLED AND SEPARATED, REQUIRING INTERVENTION. AN OPTICROSS 18 VASCULAR IMAGING CATHETER WAS USED FOR A PERIPHERAL INTERVENTION PROCEDURE FOR ARTERIAL DISEASE. DURING THE PROCEDURE, THE CATHETER TWISTED AROUND ITSELF IN THE BODY AND THEN SEPARATED. THE PROCEDURE WAS NOT COMPLETED, AND THE PATIENT WAS ALREADY SEDATED WITH GENERAL ANESTHESIA. THE PATIENT WAS TRANSPORTED TO A NEARBY HOSPITAL TO REMOVE THE CATHETER THROUGH SURGERY AND WAS ADMITTED TO THE HOSPITAL. THERE WERE NO PATIENT COMPLICATIONS AS A RESULT OF THIS EVENT.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE CATHETER BECAME TANGLED AND SEPARATED, REQUIRING INTERVENTION. AN OPTICROSS 18 VASCULAR IMAGING CATHETER WAS USED FOR A PERIPHERAL INTERVENTION PROCEDURE FOR ARTERIAL DISEASE. DURING THE PROCEDURE, THE CATHETER TWISTED AROUND ITSELF IN THE BODY AND THEN SEPARATED. THE PROCEDURE WAS NOT COMPLETED, AND THE PATIENT WAS ALREADY SEDATED WITH GENERAL ANESTHESIA. THE PATIENT WAS TRANSPORTED TO A NEARBY HOSPITAL TO REMOVE THE CATHETER THROUGH SURGERY AND WAS ADMITTED TO THE HOSPITAL. THERE WERE NO PATIENT COMPLICATIONS AS A RESULT OF THIS EVENT.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE CATHETER BECAME TANGLED AND SEPARATED, REQUIRING INTERVENTION. AN OPTICROSS 18 VASCULAR IMAGING CATHETER WAS USED FOR A PERIPHERAL INTERVENTION PROCEDURE FOR ARTERIAL DISEASE. DURING THE PROCEDURE, THE CATHETER TWISTED AROUND ITSELF IN THE BODY AND THEN SEPARATED. THE PROCEDURE WAS NOT COMPLETED, AND THE PATIENT WAS ALREADY SEDATED WITH GENERAL ANESTHESIA. THE PATIENT WAS TRANSPORTED TO A NEARBY HOSPITAL TO REMOVE THE CATHETER THROUGH SURGERY AND WAS ADMITTED TO THE HOSPITAL. THERE WERE NO PATIENT COMPLICATIONS AS A RESULT OF THIS EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1664327 OPTICROSS 18 CATHETER, ULTRASOUND, INTRAVASCULAR OBJ BOSTON SCIENTIFIC CORPORATION H7493932800180 08714729904366

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown Required Intervention