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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 H74939171061070
Medical Device Problem Code Material Rupture (1546)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 06/01/2026
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 was located at the stent graft outflow tract.A 6.0 x 100 mm, 75 cm mustang balloon catheter was advanced to the lesion site for dilatation.During the initial inflation at 16 atmospheres, the balloon was observed to have ruptured.The device was removed without reported difficulty, and the procedure was completed using another balloon catheter of the same type.No adverse patient effects were reported as a result of this event, and the patient was reported to be in stable condition following the procedure.
 
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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
+1(763)494-1632
MDR Report Key25580401
Report Number2124215-2026-33123
Device Sequence Number9277302
Product Code FGE
UDI-Device Identifier08714729793625
UDI-Public(01)08714729793625(17)281112(10)37947570
Combination Product (Y/N)N
Initial Reporter CountryJA
PMA/510(K) Number
K141521
Number of Events Summarized1
Summary Report (Y/N)N
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) 08/03/2026
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 NumberH74939171061070
Device Catalogue NumberH74939171061070
Device Lot Number0037947570
Was Device Available for Evaluation? Yes
Date Returned to Manufacturer07/01/2026
Is the Reporter a Health Professional? Yes
Was the Report Sent to FDA? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 06/01/2026
Supplement Date Received by Manufacturer07/22/2026
Initial Report FDA Received Date06/22/2026
Supplement Report FDA Received Date08/03/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured11/13/2025
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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