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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 H74939171050610
Medical Device Problem Codes Fluid/Blood Leak (1250); Material Rupture (1546)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 05/04/2026
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
D2b - pro code (product code): fge, lit.E1 - initial reporter address 1: (b)(6).G4 - premarket / 510(k) #: k141521, k141597.
 
Event or Problem Description
It was reported that balloon rupture occurred.The target lesion was located in the moderately tortuous and moderately calcified vessel.A 5.0 x 60, 135cm mustang balloon was advanced for dilation.However, during the first inflation at 16-18 atmospheres for the first 10 seconds, the balloon ruptured.The balloon was removed successfully from the patient without any device fragments left inside the patient's body.The procedure was completed with an alternate 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
mark mischke
4100 hamline ave n
arden hills, MN 55112
7634941632
MDR Report Key25354115
Report Number2124215-2026-29103
Device Sequence Number21293841
Product Code FGE
UDI-Device Identifier08714729793878
UDI-Public(01)08714729793878(17)280818(10)37239545
Combination Product (Y/N)N
Initial Reporter CountryIN
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) 06/01/2026
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 NumberH74939171050610
Device Catalogue NumberH74939171050610
Device Lot Number0037239545
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 05/10/2026
Initial Report FDA Received Date06/01/2026
Date Device Manufactured08/19/2025
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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