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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 H74939171100670
Medical Device Problem Code Material Rupture (1546)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 09/01/2026
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that balloon rupture occurred.The 70% stenosed target lesion was located in the moderately tortuous and moderately calcified vessel.A 10.0 x 60, 75cm mustang balloon catheter was advanced for dilation.During the procedure, the balloon ruptured at 8 atmospheres.The procedure was completed with another of the same device.There were no patient complications as a result of this event.
 
Additional Manufacturer Narrative
D2b - pro code (product code): fge, lit.G4 - premarket / 510(k) #: k141521, k141597.
 
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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(612)875-7234
MDR Report Key50836565
Report Number2124215-2026-50119
Device Sequence Number18717518
Product Code FGE
UDI-Device Identifier08714729794004
UDI-Public(01)08714729794004(17)290427(10)39200269
Combination Product (Y/N)N
Initial Reporter CountryKS
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
Report Date (Section B) 09/21/2026
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 NumberH74939171100670
Device Catalogue NumberH74939171100670
Device Lot Number0039200269
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 09/02/2026
Initial Report FDA Received Date09/21/2026
Date Device Manufactured04/28/2026
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 Age58 YR
Patient SexMale
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