FDA Adverse Event Malfunction Summary report: N

MUSTANG?

MDR report key: 21903992 · Received April 24, 2025

Report

Report Number
2124215-2025-26182
Event Type
Malfunction
Date Received
April 24, 2025
Date of Event
April 9, 2025
Report Date
June 16, 2025
Manufacturer
BOSTON SCIENTIFIC CORPORATION
Product Code
FGE
UDI-DI
08714729793779
PMA / PMN Number
K141521
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
JA
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

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

Additional Manufacturer Narrative · 0

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

Additional Manufacturer Narrative · 0

D2B - PRO CODE (PRODUCT CODE): FGE, LIT. G4 - PREMARKET / 510(K): K141521, K141597. 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. BLOOD WAS NOTED INSIDE THE BALLOON WHICH IS EVIDENCE OF A DEVICE LEAK. A LEAK TEST IDENTIFIED A BALLOON PINHOLE LOCATED APPROXIMATELY 38MM PROXIMAL OF THE DISTAL MARKERBAND. THE RATED BURST PRESSURE FOR THIS DEVICE AS PER SPECIFICATION 90519237 IS 20 ATMOSPHERES. A VISUAL AND TACTILE EXAMINATION FOUND NO KINKS OR DAMAGE TO THE SHAFT OF THE DEVICE. A VISUAL AND TACTILE EXAMINATION FOUND NO DAMAGE TO THE TIP OF THE DEVICE. A VISUAL EXAMINATION OBSERVED NO ISSUES WITH THE MARKERBANDS OF THE DEVICE. BOTH MARKERBANDS WERE UNDAMAGED IN THE CORRECT POSITION ON THE DEVICE.

Description of Event or Problem · 0

IT WAS REPORTED THAT BALLOON RUPTURE OCCURRED. THE 95% STENOSED TARGET LESION WAS AN AREA OF IN-STENT RESTENOSIS (ISR) LOCATED IN THE SEVERELY CALCIFIED BRACHIAL VEIN. A 7.0 X 100, 75CM MUSTANG BALLOON CATHETER WAS ADVANCED FOR DILATION. DURING FIRST INFLATION AT 20 ATMOSPHERES FOR 20 SECONDS, THE BALLOON RUPTURED. THE DEVICE WAS REMOVED USING NORMAL METHOD WITHOUT ISSUE AND THE PROCEDURE WAS COMPLETED WITH A DIFFERENT DEVICE. THERE WERE NO PATIENT COMPLICATIONS AS A RESULT OF THIS EVENT. IT WAS FURTHER REPORTED TARGET LESION WAS ALSO LOCATED IN A SEVERE TORTUOUS VEIN.

Description of Event or Problem · 0

IT WAS REPORTED THAT BALLOON RUPTURE OCCURRED. THE 95% STENOSED TARGET LESION WAS AN AREA OF IN-STENT RESTENOSIS (ISR) LOCATED IN THE SEVERELY CALCIFIED BRACHIAL VEIN. A 7.0 X 100, 75CM MUSTANG BALLOON CATHETER WAS ADVANCED FOR DILATION. DURING FIRST INFLATION AT 20 ATMOSPHERES FOR 20 SECONDS, THE BALLOON RUPTURED. THE DEVICE WAS REMOVED USING NORMAL METHOD WITHOUT ISSUE AND THE PROCEDURE WAS COMPLETED WITH A DIFFERENT DEVICE. 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 95% STENOSED TARGET LESION WAS AN AREA OF IN-STENT RESTENOSIS (ISR) LOCATED IN THE SEVERELY CALCIFIED BRACHIAL VEIN. A 7.0 X 100, 75CM MUSTANG BALLOON CATHETER WAS ADVANCED FOR DILATION. DURING FIRST INFLATION AT 20 ATMOSPHERES FOR 20 SECONDS, THE BALLOON RUPTURED. THE DEVICE WAS REMOVED USING NORMAL METHOD WITHOUT ISSUE AND THE PROCEDURE WAS COMPLETED WITH A DIFFERENT DEVICE. THERE WERE NO PATIENT COMPLICATIONS AS A RESULT OF THIS EVENT. IT WAS FURTHER REPORTED TARGET LESION WAS ALSO LOCATED IN A SEVERE TORTUOUS VEIN.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1276181 MUSTANG? STENTS, DRAINS AND DILATORS FOR THE BILIARY DUCTS FGE BOSTON SCIENTIFIC CORPORATION H74939171071070 0035568407 08714729793779

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown