FDA Adverse Event Malfunction Summary report: N

MUSTANG?

MDR report key: 21882025 · Received April 22, 2025

Report

Report Number
2124215-2025-25332
Event Type
Malfunction
Date Received
April 22, 2025
Date of Event
March 20, 2025
Report Date
June 17, 2025
Manufacturer
BOSTON SCIENTIFIC CORPORATION
Product Code
FGE
PMA / PMN Number
K103751
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CH
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

D2B - PRO CODE (PRODUCT CODE): FGE, LIT. E1 - INITIAL REPORTER FACILITY NAME: (B)(6). G4 - PREMARKET / 510(K): K103751, K110122, K141521.

Additional Manufacturer Narrative · 0

D2B - PRO CODE (PRODUCT CODE): FGE, LIT. E1 - INITIAL REPORTER FACILITY NAME: (B)(6). G4 - PREMARKET / 510(K): K103751, K110122, K141521.

Additional Manufacturer Narrative · 0

D2B - PRO CODE (PRODUCT CODE): FGE, LIT. E1 - INITIAL REPORTER FACILITY NAME: (B)(6). G4 - PREMARKET / 510(K): K103751, K110122, K141521. DEVICE EVALUATED BY MFR: THE MUSTANG WAS RETURNED FOR ANALYSIS. A VISUAL EXAMINATION IDENTIFIED THAT THE BALLOON WAS NOT FOLDED WHICH INDICATES THAT THE BALLOON WAS SUBJECTED TO POSITIVE PRESSURE. THE RATED BURST PRESSURE FOR THIS DEVICE IS 18 ATMOSPHERES AS PER MUSTANG SPECIFICATION (#90519237). THE RETURNED DEVICE WAS ATTACHED TO AN ENCORE INFLATION UNIT. THE BALLOON WAS INFLATED TO ITS RATED BURST PRESSURE OF 18 ATMOSPHERES WITH NO LEAKS OR ISSUES NOTED WITH THE BALLOON MATERIAL. A VISUAL EXAMINATION OF THE MARKERBANDS IDENTIFIED NO ISSUES. A VISUAL AND TACTILE EXAMINATION IDENTIFIED NO KINKS OR DAMAGE TO THE SHAFT. A VISUAL AND TACTILE EXAMINATION IDENTIFIED NO DAMAGE TO THE TIP.

Description of Event or Problem · 0

IT WAS REPORTED THAT BALLOON RUPTURE OCCURRED. THE TARGET LESION WAS LOCATED IN THE ARTERIOVENOUS FISTULA. A 7.0 X 150, 135CM MUSTANG BALLOON CATHETER WAS ADVANCED FOR DILATION. DURING INFLATION, THE BALLOON BURST. THERE WERE NO PATIENT COMPLICATIONS AS A RESULT OF THIS EVENT.

Description of Event or Problem · 0

IT WAS REPORTED THAT BALLOON RUPTURE OCCURRED. THE TARGET LESION WAS LOCATED IN THE ARTERIOVENOUS FISTULA. A 7.0 X 150, 135CM MUSTANG BALLOON CATHETER WAS ADVANCED FOR DILATION. DURING INFLATION, THE BALLOON BURST. THERE WERE NO PATIENT COMPLICATIONS AS A RESULT OF THIS EVENT. IT WAS FURTHER REPORTED THAT THE OVER 80% TARGET LESION WAS LOCATED IN THE MILD CALCIFIED ARTERY, THE BALLOON WAS RUPTURED UPON FIRST INFLATION AT 5 ATMOSPHERES FOR 3 SECONDS. THE DEVICE WAS REMOVED NORMALLY.

Description of Event or Problem · 0

IT WAS REPORTED THAT BALLOON RUPTURE OCCURRED. THE TARGET LESION WAS LOCATED IN THE ARTERIOVENOUS FISTULA. A 7.0 X 150, 135CM MUSTANG BALLOON CATHETER WAS ADVANCED FOR DILATION. DURING INFLATION, THE BALLOON BURST. THERE WERE NO PATIENT COMPLICATIONS AS A RESULT OF THIS EVENT. IT WAS FURTHER REPORTED THAT THE OVER 80% TARGET LESION WAS LOCATED IN THE MILD CALCIFIED ARTERY, THE BALLOON WAS RUPTURED UPON FIRST INFLATION AT 5 ATMOSPHERES FOR 3 SECONDS. THE DEVICE WAS REMOVED NORMALLY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1339310 MUSTANG? STENTS, DRAINS AND DILATORS FOR THE BILIARY DUCTS FGE BOSTON SCIENTIFIC CORPORATION H74939171071510 0034833296

Patients

Seq Age Sex Outcome Treatment
1 40 YR Unknown