REZUM
Report
- Report Number
- 2124215-2025-70578
- Event Type
- Malfunction
- Date Received
- October 6, 2025
- Date of Event
- September 9, 2025
- Report Date
- November 12, 2025
- Manufacturer
- BOSTON SCIENTIFIC CORPORATION
- Product Code
- KNS
- UDI-DI
- 08714729992547
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- SC, US
- Reporter Occupation
- PHYSICIAN
- Health Professional
- Yes
Narratives
G4: PMA/510(K) # FIELD ON 3500A FORM IS K190093, K191505 - REPORTED HERE AS PMA # EXCEEDED CHARACTER LIMIT FOR DESIGNATED FIELD.
G4: PMA/510(K) # FIELD ON 3500A FORM IS K190093, K191505 - REPORTED HERE AS PMA # EXCEEDED CHARACTER LIMIT FOR DESIGNATED FIELD. THE DEVICE IS NOT AVAILABLE FOR ANALYSIS; THEREFORE, NO PHYSICAL ANALYSIS OF THE PRODUCT COULD BE PERFORMED. THE REPORTED DEVICE PERFORMANCE ALLEGATION CANNOT BE CONFIRMED. THE DEVICE HISTORY RECORD (DHR) REVIEW CONFIRMED THAT THE DEVICE MET ALL MATERIAL, ASSEMBLY AND PERFORMANCE SPECIFICATIONS. A REVIEW OF THE DEVICE INSTRUCTIONS FOR USE (IFU) WAS COMPLETED AND DID NOT REVEAL ANY EVIDENCE OF DEVICE MISUSE, OFF LABEL USE, OR FAILURE TO FOLLOW INSTRUCTIONS. BASED ON THE INFORMATION AVAILABLE THE CAUSE THAT CONTRIBUTED TO THE REPORTED EVENT CANNOT BE ESTABLISHED.
IT WAS REPORTED THAT DURING PROCEDURE, THE DEVICE HAD TO BE DISSEMBLED BECAUSE THE NEEDLE RETRACTION BUTTON FAILED. THE EMERGENCY NOSE CONE RELEASE PIN WAS PULLED. A SECOND DEVICE WAS OPENED BUT IT PRESENTED THE SAME ISSUE. THE PROCEDURE WAS CANCELLED. THERE WERE NO PATIENT COMPLICATIONS REPORTED. THIS EVENT IS BEING REPORTED FOR ABORTED/CANCELLED PROCEDURE WITH A PATIENT UNDER ANESTHESIA OR SEDATION STATUS UNKNOWN.
IT WAS REPORTED THAT DURING PROCEDURE, THE DEVICE HAD TO BE DISSEMBLED BECAUSE THE NEEDLE RETRACTION BUTTON FAILED. THE EMERGENCY NOSE CONE RELEASE PIN WAS PULLED. A SECOND DEVICE WAS OPENED BUT IT PRESENTED THE SAME ISSUE. THE PROCEDURE WAS CANCELLED. THERE WERE NO PATIENT COMPLICATIONS REPORTED. THIS EVENT IS BEING REPORTED FOR ABORTED/CANCELLED PROCEDURE WITH A PATIENT UNDER ANESTHESIA OR SEDATION STATUS UNKNOWN.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 2488416 | REZUM | UNIT, ELECTROSURGICAL ENDOSCOPIC (WITH OR WITHOUT ACCESSORIES) | KNS | BOSTON SCIENTIFIC CORPORATION | M006D2201-003 | 0036796824 | 08714729992547 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | NA | Unknown |