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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BOSTON SCIENTIFIC CORPORATION MUSTANG?; STENTS, DRAINS AND DILATORS FOR THE BILIARY DUCTS

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BOSTON SCIENTIFIC CORPORATION MUSTANG?; STENTS, DRAINS AND DILATORS FOR THE BILIARY DUCTS Back to Search Results
Model Number H74939171071070
Medical Device Problem Code Material Rupture (1546)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 10/24/2025
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
D2b: pro code: (product code): fge, lit.G4: premarket / 510(k): k141521, k141597.Good faith effort attempts were made to try and retrieve additional details regarding the reported event, but further information was unable to be obtained.
 
Event or Problem Description
It was reported that a balloon rupture occurred.The 90% stenosed target lesion was located in the moderately tortuous and moderately calcified vein.A 7.0 x 100, 75cm mustang balloon catheter was advanced for dilation.During the first inflation at 6 atmospheres for 10 seconds, the balloon ruptured in a pinhole form.The device was removed using normal method without issue and the procedure was completed with another of same device.There were no patient complications as a result of this event.
 
Event or Problem Description
It was reported that a balloon rupture occurred.The 90% stenosed target lesion was located in the moderately tortuous and moderately calcified vein.A 7.0 x 100, 75cm mustang balloon catheter was advanced for dilation.During the first inflation at 6 atmospheres for 10 seconds, the balloon ruptured in a pinhole form.The device was removed using normal method without issue and the procedure was completed with another of same device.There were no patient complications as a result of this event.It was further reported that the patient's anatomy was not considered challenging, and no patient-related factors contributed to the event.Additionally, no procedural factors were identified as contributing to the occurrence.
 
Additional Manufacturer Narrative
A2 - age at time of event: 18 years or older.B5: describe event or problem: updated to include new information obtained.D2b: pro code: (product code): fge, lit.G4: premarket / 510(k): k141521, k141597.
 
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Brand Name
MUSTANG?
Common Device Name
STENTS, DRAINS AND DILATORS FOR THE BILIARY DUCTS
Manufacturer (Section D)
BOSTON SCIENTIFIC CORPORATION
300 boston scientific way
marlborough MA 01752
Manufacturer (Section G)
BOSTON SCIENTIFIC CORPORATION
pmt 741 persiaran cassia selat
bandarcassia, pulau pinan 14110
MY   14110
Manufacturer Contact
rachel shields
4100 hamline ave n
arden hills, MN 55112
6512422111
MDR Report Key23506890
Report Number2124215-2025-81131
Device Sequence Number9140791
Product Code FGE
UDI-Device Identifier08714729793779
UDI-Public(01)08714729793779(17)270730(10)34533356
Combination Product (Y/N)N
Initial Reporter CountryJA
PMA/510(K) Number
K141521
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)Unknown
Reporter Type Manufacturer
Report Source Other,Foreign,Health Professional,Company Representative
Initial Reporter Occupation Physician
Type of Report Initial,Followup
Report Date (Section B) 11/19/2025
1 Device was Involved in the Event
1 Patient was Involved in the Event
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Operator of Device Health Professional
Device Model NumberH74939171071070
Device Catalogue NumberH74939171071070
Device Lot Number0034533356
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 10/24/2025
Supplement Date Received by Manufacturer11/13/2025
Initial Report FDA Received Date11/09/2025
Supplement Report FDA Received Date11/19/2025
Date Device Manufactured07/30/2024
Is the Device Labeled for Single Use? (Y/N) Yes
Is This a Single-Use Device that was
Reprocessed and Reused on a Patient? (Y/N)
No
Usage of Device Initial
Patient Sequence Number1
Patient SexUnknown
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