FDA Adverse Event Malfunction Summary report: N

CAPIO SLIM

MDR report key: 23759647 · Received December 9, 2025

Report

Report Number
2124215-2025-89003
Event Type
Malfunction
Date Received
December 9, 2025
Date of Event
November 7, 2025
Report Date
February 23, 2026
Manufacturer
BOSTON SCIENTIFIC CORPORATION
Product Code
PWI
UDI-DI
08714729842224
PMA / PMN Number
K172060
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NE, US
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

BLOCK H6: IMDRF DEVICE CODE A050502 CAPTURES THE REPORTABLE EVENT OF DEVICE MISFIRED.

Additional Manufacturer Narrative · 0

BLOCK H6: IMDRF DEVICE CODE A050502 CAPTURES THE REPORTABLE EVENT OF DEVICE MISFIRED.

Description of Event or Problem · 0

IT WAS REPORTED THAT DURING THE SACROSPINOUS LIGAMENT PROCEDURE, TWO CAPIO SLIM DEVICES MISFIRED. THE PROCEDURE WAS COMPLETED USING ANOTHER CAPIO DEVICE. NO PATIENT COMPLICATIONS WERE REPORTED. NOTE: THIS REPORT PERTAINS TO ONE OF TWO DEVICES USED DURING THE SAME PROCEDURE. REFER TO MANUFACTURER REPORT NUMBER 2124215-2025-89001 FOR THE FIRST CAPIO SLIM DEVICE, AND 2124215-2025-89003 FOR THE SECOND CAPIO SLIM DEVICE.

Description of Event or Problem · 0

IT WAS REPORTED THAT DURING THE SACROSPINOUS LIGAMENT PROCEDURE, TWO CAPIO SLIM DEVICES MISFIRED. THE PROCEDURE WAS COMPLETED USING ANOTHER CAPIO DEVICE. NO PATIENT COMPLICATIONS WERE REPORTED. NOTE: THIS REPORT PERTAINS TO ONE OF TWO DEVICES USED DURING THE SAME PROCEDURE. REFER TO MANUFACTURER REPORT NUMBER 2124215-2025-89001 FOR THE FIRST CAPIO SLIM DEVICE, AND 2124215-2025-89003 FOR THE SECOND CAPIO SLIM DEVICE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2721762 CAPIO SLIM SPECIALIZED SURGICAL INSTRUMENTATION FOR USE WITH UROGYNECOLOGIC SURGICAL MESH PWI BOSTON SCIENTIFIC CORPORATION M0068318261 0036381047 08714729842224

Patients

Seq Age Sex Outcome Treatment
1 NA Female