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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 H74939171070670
Medical Device Problem Code Material Rupture (1546)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 04/05/2026
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
D2b: pro code: (product code): fge, lit.G4: premarket / 510(k): k141521, k141597.
 
Event or Problem Description
It was reported that a balloon rupture occurred.The target lesion, exhibiting 80% stenosis, was located within a moderately tortuous and moderately calcified arteriovenous fistula (avf).A 7.0 x 60 mm, 75 cm mustang balloon catheter was advanced to the lesion site for dilation.During inflation at 23 atmospheres, the balloon failed to expand, and a tear in the device was noted.The procedure was completed using a different device.No patient complications were noted 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
mark mischke
4100 hamline ave n
arden hills, MN 55112
7634941632
MDR Report Key24991826
Report Number2124215-2026-22492
Device Sequence Number18725173
Product Code FGE
UDI-Device Identifier08714729793861
UDI-Public(01)08714729793861(17)280708(10)36923830
Combination Product (Y/N)N
Initial Reporter CountryKS
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) 04/25/2026
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 NumberH74939171070670
Device Catalogue NumberH74939171070670
Device Lot Number0036923830
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 04/05/2026
Initial Report FDA Received Date04/25/2026
Date Device Manufactured07/09/2025
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 Age77 YR
Patient SexMale
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