FDA Adverse Event Malfunction Summary report: N

PERCUFLEX PLUS

MDR report key: 22921140 · Received August 29, 2025

Report

Report Number
2124215-2025-59610
Event Type
Malfunction
Date Received
August 29, 2025
Date of Event
August 4, 2025
Report Date
October 6, 2025
Manufacturer
BOSTON SCIENTIFIC CORPORATION
Product Code
FAD
PMA / PMN Number
K924608
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
TU
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

BLOCK H6: DEVICE CODE A040501 CAPTURES THE REPORTABLE EVENT OF STENT CALCIFIED. BLOCKS B5, B6, AND B7, HAVE BEEN UPDATED BASED ON THE ADDITIONAL INFORMATION PROVIDED ON SEPTEMBER 15, 2025.

Additional Manufacturer Narrative · 0

BLOCK H6: DEVICE CODE A040501 CAPTURES THE REPORTABLE EVENT OF STENT CALCIFIED.

Description of Event or Problem · 0

IT WAS REPORTED THAT A PERCUFLEX PLUS URETERAL STENT WAS IMPLANTED IN THE PATIENT. FOLLOWING THE PROCEDURE, ON (B)(6) 2025, A STENT REPLACEMENT PROCEDURE WAS PERFORMED, AND THE STENT WAS FOUND TO BE ENCRUSTED. THE ENCRUSTED STENT WAS REMOVED, AND A NEW STENT OF THE SAME MODEL WAS PLACED WHICH SUCCESSFULLY COMPLETED THE PROCEDURE. THERE WERE NO PATIENT COMPLICATIONS REPORTED.

Description of Event or Problem · 0

IT WAS REPORTED THAT A PERCUFLEX PLUS URETERAL STENT WAS IMPLANTED IN THE PATIENT. FOLLOWING THE PROCEDURE, A STENT REPLACEMENT PROCEDURE WAS PERFORMED WITHIN 2 MONTHS. THE STENT WAS FOUND TO BE ENCRUSTED AND WAS SUCCESSFULLY REMOVED. THERE WAS NO INFORMATION IF A NEW STENT WAS PLACED AND THERE WERE NO PATIENT COMPLICATIONS REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2879224 PERCUFLEX PLUS CATHETER, BILIARY, DIAGNOSTIC FAD BOSTON SCIENTIFIC CORPORATION M0061752530 0033225046

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown