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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 H74939171051070
Medical Device Problem Code Material Rupture (1546)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 12/19/2025
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 balloon rupture occurred.A 5.0 x 100, 75cm mustang balloon catheter was advanced for dilatation.During the first inflation, the balloon ruptured.The device was removed without any problem, and the procedure was completed with another of same device.There were no patient complications as a result of this event.
 
Additional Manufacturer Narrative
D2b: pro code: (product code): fge, lit.G4: premarket / 510(k): k141521, k141597.The device was returned for analysis.A visual examination identified that the balloon was not folded which indicates that the balloon was subjected to positive pressure.A longitudinal tear was identified in the balloon material, which confirms the event.The tear measured approximately 25mm in length and extended from a position 22mm proximal of the distal markerband to 1mm distal of the distal markerband.A visual examination revealed no damage to the device tip.Visual and tactile inspection identified no kinks or damage to the device shaft.Both marker bands were present and intact on the shaft of the device.
 
Event or Problem Description
It was reported that balloon rupture occurred.A 5.0 x 100, 75cm mustang balloon catheter was advanced for dilatation.During the first inflation, the balloon ruptured.The device was removed without any problem, and the procedure was completed with another of same device.There were no patient complications as a result of this event.
 
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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 Key23888886
Report Number2124215-2025-92962
Device Sequence Number4671501
Product Code FGE
UDI-Device Identifier08714729793892
UDI-Public(01)08714729793892(17)281017(10)37737155
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,Distributor
Initial Reporter Occupation Physician
Type of Report Initial,Followup
Report Date (Section B) 02/25/2026
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 NumberH74939171051070
Device Catalogue NumberH74939171051070
Device Lot Number0037737155
Was Device Available for Evaluation? Device Returned to Manufacturer
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 12/19/2025
Supplement Date Received by Manufacturer02/05/2026
Initial Report FDA Received Date12/24/2025
Supplement Report FDA Received Date02/25/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured10/18/2025
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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