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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 H74939171051010
Medical Device Problem Code Material Rupture (1546)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 02/12/2026
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
D2b: pro code: (product code): fge, lit.G4: premarket/510(k): k141521, k141597.E1: initial reporter facility name: (b)(6) medical center.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 100% stenosed target lesion was located in the moderately tortuous and severely calcified right superficial femoral artery.A 5.0 x 100 mm, 135 cm mustang balloon catheter was advanced for dilatation.During the initial inflation at 10 atmospheres for 30 seconds, the balloon ruptured.A second inflation was performed at 10 atmospheres for 10 seconds.The device was removed, and the procedure was completed with a different device.No patient complications were reported as a result of the 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 Key24480273
Report Number2124215-2026-11280
Device Sequence Number10308219
Product Code FGE
UDI-Device Identifier08714729793533
UDI-Public(01)08714729793533(17)260614(10)31823293
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
Report Date (Section B) 03/02/2026
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 Expiration Date06/14/2026
Device Model NumberH74939171051010
Device Catalogue NumberH74939171051010
Device Lot Number0031823293
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 02/12/2026
Initial Report FDA Received Date03/02/2026
Date Device Manufactured06/15/2023
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
Concomitant Medical Products
and Therapy/Usage Dates
GUIDEWIRE: RADIFOCUS.; INFLATION DEVICE: NIPRO.; INTRODUCER SHEATH: DESTINATION 6F.
Patient SexUnknown
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