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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BOSTON SCIENTIFIC CORPORATION MUSTANG; CATHETER, BILIARY, DIAGNOSTIC

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BOSTON SCIENTIFIC CORPORATION MUSTANG; CATHETER, BILIARY, DIAGNOSTIC Back to Search Results
Model Number 24672
Device Problem Material Rupture (1546)
Patient Problem No Consequences Or Impact To Patient (2199)
Event Date 12/05/2019
Event Type  malfunction  
Event Description
It was reported that balloon burst occurred.A percutaneous transluminal angioplasty procedure was being performed.The 10% stenosed target lesion was located in the calcified and mildly tortuous superficial femoral artery.After deploying an eluvia stent, this 5.0 x 150, 135cm mustang balloon catheter was selected, when preparing for inflation angiography revealed contrast agent coming out from the device.When the device was removed from the patient, they found that the balloon had burst.The procedure was completed with another of the same device.No patient complications was reported.
 
Event Description
It was reported that balloon burst occurred.A percutaneous transluminal angioplasty procedure was being performed.The 10% stenosed target lesion was located in the calcified and mildly tortuous superficial femoral artery.After deploying an eluvia stent, this 5.0 x 150, 135cm mustang balloon catheter was selected, when preparing for inflation angiography revealed contrast agent coming out from the device.When the device was removed from the patient, they found that the balloon had burst.The procedure was completed with another of the same device.No patient complications was reported.
 
Manufacturer Narrative
Complaint device was returned for analysis.Blood was identified in the balloon which is indicative of a device leak.The returned device was loaded onto a mandrel and attached to an encore inflation unit.Positive pressure was applied, and a pinhole leak was identified mid balloon.No other issues were noted.A visual and microscopic examination of the balloon material identified no issues that could have contributed to the complaint incident.A visual and microscopic examination of the markerbands identified no issues which may potentially have contributed to the complaint incident.A visual and tactile examination identified no kinks or damage to the shaft which may have potentially contributed to the complaint incident.A visual and tactile examination identified no damage to the tip which may have potentially contributed to the complaint incident.No other issues were identified during the product analysis.
 
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Brand Name
MUSTANG
Type of Device
CATHETER, BILIARY, DIAGNOSTIC
Manufacturer (Section D)
BOSTON SCIENTIFIC CORPORATION
two scimed place
maple grove MN 55311
MDR Report Key9453517
MDR Text Key176238857
Report Number2134265-2019-15564
Device Sequence Number1
Product Code LIT
UDI-Device Identifier08714729793434
UDI-Public08714729793434
Combination Product (y/n)N
PMA/PMN Number
K103751
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type company representative,distri
Type of Report Initial,Followup
Report Date 03/03/2020
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received12/11/2019
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Operator Health Professional
Device Expiration Date03/13/2022
Device Model Number24672
Device Catalogue Number24672
Device Lot Number0023486132
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer01/09/2020
Date Manufacturer Received02/13/2020
Is This a Reprocessed and Reused Single-Use Device? No
Patient Sequence Number1
Patient Age72 YR
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