FDA Adverse Event Malfunction Summary report: N

MUSTANG

MDR report key: 21366175 · Received February 12, 2025

Report

Report Number
2124215-2025-07853
Event Type
Malfunction
Date Received
February 12, 2025
Date of Event
January 20, 2025
Report Date
March 11, 2025
Manufacturer
BOSTON SCIENTIFIC CORPORATION
Product Code
FGE
UDI-DI
08714729793625
PMA / PMN Number
K141521
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
KS
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

D2B - ADDITIONAL PRO CODE (PRODUCT CODE): LIT G4 - ADDITIONAL PREMARKET / 510(K): K141597.

Additional Manufacturer Narrative · 0

D2B - PRO CODE (PRODUCT CODE): FGE, LIT. G4 - PREMARKET / 510(K): K141521, K141597.

Description of Event or Problem · 0

IT WAS REPORTED THAT BALLOON RUPTURE OCCURRED. A 6.0 X 100, 75CM MUSTANG BALLOON CATHETER WAS ADVANCED FOR DILATION. DURING INFLATION, THE BALLOON RUPTURED WITHIN THE LESION. NO COMPLICATIONS REPORTED, AND THE PATIENT WAS IN VERY GOOD CONDITION.

Description of Event or Problem · 0

IT WAS REPORTED THAT BALLOON RUPTURE OCCURRED. A 6.0 X 100 MUSTANG BALLOON CATHETER WAS ADVANCED FOR DILATION. DURING INFLATION, THE BALLOON RUPTURED WITHIN THE LESION. NO COMPLICATIONS REPORTED, AND THE PATIENT WAS IN VERY GOOD CONDITION. IT WAS FURTHER REPORTED THAT THE 100% STENOSED TARGET LESION WAS LOCATED IN THE RADIOCEPHALIC FISTULA. THE DEVICE WAS SELECTED FOR ARTERIOVENOUS FISTULA PERCUTANEOUS TRANSLUMINAL ANGIOPLASTY (AVF PTA). THE DEVICE WAS REMOVED WITHOUT ANY ISSUES, AND THE PROCEDURE WAS COMPLETED ANOTHER OF THE SAME DEVICE. NO COMPLICATIONS WERE REPORTED, AND THE PATIENT WAS IN GOOD CONDITION AFTER THE PROCEDURE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
904491 MUSTANG STENTS, DRAINS AND DILATORS FOR THE BILIARY DUCTS FGE BOSTON SCIENTIFIC CORPORATION H74939171061070 0034710177 08714729793625

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown