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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 H74939171080470
Medical Device Problem Codes Inflation Problem (1310); Adverse Event Without Identified Device or Use Problem (2993)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 03/25/2026
Type of Reportable Event Malfunction
Event or Problem Description
Reportable based on device analysis completed on 08jun2026.It was reported that the balloon failed to inflate.The stenosed target lesion was located in the arteriovenous fistula.An 8.0 x 40, 75cm mustang balloon catheter was selected for use.However, during the procedure, it was noted that the balloon did not expand.The procedure was completed with another of the same device.There were no patient complications as a result of this event.However, device analysis revealed a longitudinal tear was identified in the balloon material.
 
Additional Manufacturer Narrative
D2b - pro code (product code): fge, lit g4 - premarket / 510(k) #: k141521, k141597 device analysis findings: upon receipt at our post market quality assurance laboratory, 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.The tear measured approximately 40mm in length and extended from a position 4mm proximal of the proximal markerband to 5mm distal of the distal markerband.From the longitudinal tear a partial circumferential tear was noted approximately 3mm distal from the proximal markerband.The investigator was unable to inflate the balloon due to the tear in the balloon.A visual examination observed no damage to the tip of the device.A visual and tactile examination found no kinks or damage to the shaft of the device.Both markerbands were undamaged and present on the shaft of the device.This concludes the product analysis.Device history record: it was confirmed this device met manufacturing specification prior to distribution and there were no manufacturing deviations which could have contributed to the reported event.Labeling review: review of the instructions for use (ifu) confirmed there was relevant content and sufficient guidance with respect to the circumstances described within this complaint.No updates are required to the ifu as a result of this event.Risk review: a review of the mustang device confirmed that the reported event is a known event defined in the product's risk management documentation.This event type has been accounted for during product risk analysis to support acceptable risk benefit for the product.Investigation conclusion: based on a thorough review of the reported complaint, boston scientific has assigned an investigation conclusion code of adverse event related to 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
7634941632
MDR Report Key25587721
Report Number2124215-2026-33153
Device Sequence Number5481796
Product Code FGE
UDI-Device Identifier08714729793328
UDI-Public(01)08714729793328(17)281124(10)38041302
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) 06/22/2026
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 NumberH74939171080470
Device Catalogue NumberH74939171080470
Device Lot Number0038041302
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer05/07/2026
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 06/08/2026
Initial Report FDA Received Date06/22/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured11/25/2025
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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