FDA Adverse Event Malfunction Summary report: N

MUSTANG?

MDR report key: 22882501 · Received August 25, 2025

Report

Report Number
2124215-2025-55579
Event Type
Malfunction
Date Received
August 25, 2025
Date of Event
July 31, 2025
Report Date
October 24, 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: FGE, LIT. G4: PREMARKET / 510(K): K141521, K141597.

Additional Manufacturer Narrative · 0

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

Description of Event or Problem · 0

IT WAS REPORTED THAT BALLOON RUPTURE OCCURRED. THE 100% STENOSED TARGET LESION WAS LOCATED IN THE MODERATELY TORTUOUS AND SEVERELY CALCIFIED UPPER ARM SHUNT. A 7.0 X 100, 75CM MUSTANG COYOTE ES BALLOON CATHETER WAS ADVANCED FOR DILATATION. HOWEVER, DURING SECOND INFLATION AT 20 ATMOSPHERES FOR 10 SECONDS, THE BALLOON RUPTURED. THE DEVICE WAS REMOVED, AND THE PROCEDURE WAS COMPLETED WITH ANOTHER OF THE SAME DEVICE. NO PATIENT INJURIES REPORTED, AND THE PATIENT CONDITION WAS GOOD POST-PROCEDURE.

Description of Event or Problem · 0

IT WAS REPORTED THAT BALLOON RUPTURE OCCURRED. THE 100% STENOSED TARGET LESION WAS LOCATED IN THE MODERATELY TORTUOUS AND SEVERELY CALCIFIED UPPER ARM SHUNT. A 7.0 X 100, 75CM MUSTANG COYOTE ES BALLOON CATHETER WAS ADVANCED FOR DILATATION. HOWEVER, DURING SECOND INFLATION AT 20 ATMOSPHERES FOR 10 SECONDS, THE BALLOON RUPTURED. THE DEVICE WAS REMOVED, AND THE PROCEDURE WAS COMPLETED WITH ANOTHER OF THE SAME DEVICE. NO PATIENT INJURIES REPORTED, AND THE PATIENT CONDITION WAS GOOD POST-PROCEDURE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2872203 MUSTANG? STENTS, DRAINS AND DILATORS FOR THE BILIARY DUCTS FGE BOSTON SCIENTIFIC CORPORATION H74939171071070 0030195276 08714729793779

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown