FDA Adverse Event Malfunction Summary report: N

SPEEDBAND SUPERVIEW SUPER 7

MDR report key: 22829846 · Received August 18, 2025

Report

Report Number
3005099803-2025-03999
Event Type
Malfunction
Date Received
August 18, 2025
Date of Event
July 25, 2025
Report Date
January 2, 2026
Manufacturer
BOSTON SCIENTIFIC CORPORATION
Product Code
MND
UDI-DI
08714729201960
PMA / PMN Number
510K EXEMPT
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MA, US
Reporter Occupation
003

Narratives

Additional Manufacturer Narrative · 0

BLOCK E1: THIS EVENT WAS REPORTED BY A BSC SALES REP. THE REPORTED HEALTHCARE FACILITY IS: (B)(6). BLOCK H2: CORRECTION: BLOCK H6 (DEVICE CODES (1)) AND BLOCK H11 (ADDITIONAL MFR NARRATIVE). BLOCK H6: IMDRF DEVICE CODE A050502 CAPTURES THE REPORTABLE EVENT OF BANDS UNABLE TO DEPLOY.

Additional Manufacturer Narrative · 0

BLOCK E1: (B)(6). BLOCK H6: IMDRF DEVICE CODE A050502 CAPTURES THE REPORTABLE EVENT OF BANDS MISFIRE.

Description of Event or Problem · 0

IT WAS REPORTED TO BOSTON SCIENTIFIC CORPORATION THAT A SPEEDBAND SUPERVIEW SUPER 7 WAS USED FOR VARICES DURING AN ESOPHAGOGASTRODUODENOSCOPY (EGD) PROCEDURE PERFORMED ON (B)(6) 2025. DURING THE PROCEDURE, THE BANDS WERE NOT DEPLOYING CORRECTLY. THE PROCEDURE WAS COMPLETED WITH THIS DEVICE. THERE WERE NO PATIENT COMPLICATIONS REPORTED AS A RESULT OF THIS EVENT.

Description of Event or Problem · 0

IT WAS REPORTED TO BOSTON SCIENTIFIC CORPORATION THAT A SPEEDBAND SUPERVIEW SUPER 7 WAS USED FOR VARICES DURING AN ESOPHAGOGASTRODUODENOSCOPY (EGD) PROCEDURE PERFORMED ON (B)(6) 2025. DURING THE PROCEDURE, THE BANDS WERE NOT DEPLOYING CORRECTLY. THE PROCEDURE WAS COMPLETED WITH THIS DEVICE. THERE WERE NO PATIENT COMPLICATIONS REPORTED AS A RESULT OF THIS EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2044471 SPEEDBAND SUPERVIEW SUPER 7 LIGATOR, ESOPHAGEAL MND BOSTON SCIENTIFIC CORPORATION M00542251 0035386369 08714729201960

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown