FDA Adverse Event Malfunction Summary report: N

EMERGE?

MDR report key: 23113743 · Received September 22, 2025

Report

Report Number
2124215-2025-64579
Event Type
Malfunction
Date Received
September 22, 2025
Date of Event
July 2, 2025
Report Date
December 11, 2025
Manufacturer
BOSTON SCIENTIFIC CORPORATION
Product Code
LOX
UDI-DI
08714729806189
PMA / PMN Number
K121196
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CH
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

E1 - INITIAL REPORTER EMAIL. G4 - PREMARKET: K163174. DEVICE EVALUATED BY MFR.: THE DEVICE FG EMERGE MR, US 1.50MM X 15MM WAS RETURNED FOR ANALYSIS. VISUAL, TACTILE, MICROSCOPIC AND WIRE INSERTION ANALYSIS WAS PERFORMED ON THE DEVICE. NO ISSUES WERE NOTED ON THE BALLOON PROFILE. A KINK WAS IDENTIFIED ON THE HYPOTUBE, 25.2CM DISTAL TO THE DISTAL END OF THE STAIN RELIEF. A DETAILED MICROSCOPIC EXAMINATION OF THE BALLOON MATERIAL IDENTIFIED NO TEARS OR PINHOLES IN THE BALLOON. MICROSCOPIC EXAMINATION OF THE SHAFT IDENTIFIED A PROLAPSED AND STRETCHED INNER WIRE LUMEN, 6.5CM FROM TIP OF DEVICE WITH A PROTRUDING OUTER LUMEN, 7CM FROM THE TIP. TIP SHOWED NO SIGNS OF TIP DAMAGE. A MICROSCOPIC EXAMINATION OF THE PROXIMAL AND DISTAL MARKERBANDS IDENTIFIED NO DAMAGE. THE DEVICE COULD NOT BE LOADED OR TRACKED ON A TEST GUIDEWIRE DUE TO THE DAMAGE ON THE INNER WIRE LUMEN. NO OTHER DEVICE ISSUES WERE IDENTIFIED DURING RETURNED PRODUCT ANALYSIS.

Additional Manufacturer Narrative · 0

G4 - PREMARKET: K163174. DEVICE EVALUATED BY MFR.: THE DEVICE FG EMERGE MR, US 1.50MM X 15MM WAS RETURNED FOR ANALYSIS. VISUAL, TACTILE, MICROSCOPIC AND WIRE INSERTION ANALYSIS WAS PERFORMED ON THE DEVICE. NO ISSUES WERE NOTED ON THE BALLOON PROFILE. A KINK WAS IDENTIFIED ON THE HYPOTUBE, 25.2CM DISTAL TO THE DISTAL END OF THE STAIN RELIEF. A DETAILED MICROSCOPIC EXAMINATION OF THE BALLOON MATERIAL IDENTIFIED NO TEARS OR PINHOLES IN THE BALLOON. MICROSCOPIC EXAMINATION OF THE SHAFT IDENTIFIED A PROLAPSED AND STRETCHED INNER WIRE LUMEN, 6.5CM FROM TIP OF DEVICE WITH A PROTRUDING OUTER LUMEN, 7CM FROM THE TIP. TIP SHOWED NO SIGNS OF TIP DAMAGE. A MICROSCOPIC EXAMINATION OF THE PROXIMAL AND DISTAL MARKERBANDS IDENTIFIED NO DAMAGE. THE DEVICE COULD NOT BE LOADED OR TRACKED ON A TEST GUIDEWIRE DUE TO THE DAMAGE ON THE INNER WIRE LUMEN. NO OTHER DEVICE ISSUES WERE IDENTIFIED DURING RETURNED PRODUCT ANALYSIS.

Description of Event or Problem · 0

REPORTABLE BASED ON DEVICE ANALYSIS COMPLETED ON 26AUG2025. IT WAS REPORTED THAT DIFFICULTY TRACKING OVER THE WIRE WERE ENCOUNTERED. THE TARGET LESION WAS LOCATED IN THE CORONARY ARTERY. THE 1.50MM X 15MM EMERGE? BALLOON CATHETER WAS ADVANCED. HOWEVER, DURING INSERTION, THE GUIDEWIRE COULD NOT CROSS THE PORT. THE PROCEDURE WAS COMPLETED WITH ANOTHER OF THE SAME DEVICE. THERE WERE NO PATIENT COMPLICATIONS REPORTED AND THE PATIENT STATUS WAS STABLE POST-PROCEDURE. HOWEVER, RETURNED DEVICE ANALYSIS REVEALED A TEAR ON THE OUTER LUMEN.

Description of Event or Problem · 0

REPORTABLE BASED ON DEVICE ANALYSIS COMPLETED ON 26AUG2025. IT WAS REPORTED THAT DIFFICULTY TRACKING OVER THE WIRE WERE ENCOUNTERED. THE TARGET LESION WAS LOCATED IN THE CORONARY ARTERY. THE 1.50MM X 15MM EMERGE? BALLOON CATHETER WAS ADVANCED. HOWEVER, DURING INSERTION, THE GUIDEWIRE COULD NOT CROSS THE PORT. THE PROCEDURE WAS COMPLETED WITH ANOTHER OF THE SAME DEVICE. THERE WERE NO PATIENT COMPLICATIONS REPORTED AND THE PATIENT STATUS WAS STABLE POST-PROCEDURE. HOWEVER, RETURNED DEVICE ANALYSIS REVEALED A TEAR ON THE OUTER LUMEN.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1959985 EMERGE? CATHETERS, TRANSLUMINAL CORONARY ANGIOPLASTY, PERCUTANEOUS LOX BOSTON SCIENTIFIC CORPORATION H7493918915150 0034344414 08714729806189

Patients

Seq Age Sex Outcome Treatment
1 71 YR Female