FDA Adverse Event Malfunction Summary report: N

PERCUFLEX

MDR report key: 23659384 · Received November 26, 2025

Report

Report Number
2124215-2025-86778
Event Type
Malfunction
Date Received
November 26, 2025
Date of Event
October 28, 2025
Report Date
March 3, 2026
Manufacturer
BOSTON SCIENTIFIC CORPORATION
Product Code
FAD
UDI-DI
08714729040279
PMA / PMN Number
K834468
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CH
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

BLOCK H6: DEVICE CODE A0406 CAPTURES THE REPORTABLE EVENT OF STENT MATERIAL DEFORMATION INSIDE THE PATIENT. DEVICE CODE A040609 CAPTURES THE REPORTABLE EVENT OF KINKED INSIDE THE PATIENT.

Additional Manufacturer Narrative · 0

DEVICE CODE A0406 CAPTURES THE REPORTABLE EVENT OF STENT MATERIAL DEFORMATION INSIDE THE PATIENT. DEVICE CODE A040609 CAPTURES THE REPORTABLE EVENT OF KINKED INSIDE THE PATIENT. INVESTIGATION ANALYSIS: UPON RECEIPT AT OUR QUALITY ASSURANCE LABORATORY, THIS PERCUFLEX URETERAL STENT UNDERWENT A THOROUGH ANALYSIS. VISUAL ANALYSIS OF THE RETURNED DEVICE IDENTIFIED THAT THE RENAL COIL WAS KINKED. A REVIEW OF THE DEVICE HISTORY RECORD (DHR) INDICATED THAT THE DEVICE MET ALL MATERIAL, ASSEMBLY, AND PRODUCT SPECIFICATIONS AT THE TIME OF RELEASE TO DISTRIBUTION. BASED ON THE INFORMATION AVAILABLE AND ANALYSIS RESULTS, IT IS POSSIBLE TO CONCLUDE THAT THIS ISSUE COULD BE CAUSED BY OPERATIONAL FACTORS, PROBABLY DUE TO SOME MANIPULATION DURING THE PROCEDURE THAT COULD HAVE CAUSED THE KINKS. A CONCLUSION CODE OF ADVERSE EVENT RELATED TO PROCEDURE WAS ASSIGNED TO THIS INVESTIGATION.

Description of Event or Problem · 0

IT WAS REPORTED THAT A PERCUFLEX URETERAL STENT WAS USED DURING A LITHOTRIPSY PROCEDURE. DURING THE PROCEDURE AND INSIDE THE PATIENT, IT WAS NOTICED THAT THE STENT WAS FOLDED AND TWISTED AND COULD NOT BE USED. THE PROCEDURE WAS COMPLETED WITH ANOTHER OF THE SAME DEVICE AND THERE WERE NO PATIENT COMPLICATIONS REPORTED.

Description of Event or Problem · 0

IT WAS REPORTED THAT A PERCUFLEX URETERAL STENT WAS USED DURING A LITHOTRIPSY PROCEDURE. DURING THE PROCEDURE AND INSIDE THE PATIENT, IT WAS NOTICED THAT THE STENT WAS FOLDED AND TWISTED AND COULD NOT BE USED. THE PROCEDURE WAS COMPLETED WITH ANOTHER OF THE SAME DEVICE AND THERE WERE NO PATIENT COMPLICATIONS REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2673134 PERCUFLEX CATHETER, BILIARY, DIAGNOSTIC FAD BOSTON SCIENTIFIC CORPORATION M0061453520 0034386010 08714729040279

Patients

Seq Age Sex Outcome Treatment
1 56 YR Male