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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 H74939171100470
Medical Device Problem Code Material Rupture (1546)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 09/02/2026
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that balloon burst occurred.The 100% stenosed target lesion was located in the mildly tortuous and moderately calcified arteriovenous (av) shunt.A 10.0 x 40, 75cm mustang balloon catheter was advanced for dilation.During the procedure, the balloon burst at 12 atmospheres before inflating to the nominal burst pressure (nbp).The procedure was completed with another of same device.There were no patient complications as a result of this event, and the patient was stable post-procedure.
 
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 Key50838950
Report Number2124215-2026-50136
Device Sequence Number9957509
Product Code FGE
UDI-Device Identifier08714729793359
UDI-Public(01)08714729793359(17)290608(10)39533452
Combination Product (Y/N)N
Initial Reporter CountryTW
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 NumberH74939171100470
Device Catalogue NumberH74939171100470
Device Lot Number0039533452
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 09/07/2026
Initial Report FDA Received Date09/21/2026
Date Device Manufactured06/09/2026
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 SexUnknown
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