FDA Adverse Event
Malfunction
Summary report: N
MUSTANG?
MDR report key: 22898367
·
Received August 26, 2025
Report
- Report Number
- 2124215-2025-59682
- Event Type
- Malfunction
- Date Received
- August 26, 2025
- Date of Event
- August 8, 2025
- Report Date
- August 26, 2025
- Manufacturer
- BOSTON SCIENTIFIC CORPORATION
- Product Code
- LIT
- UDI-DI
- 08714729794578
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- KS
- Reporter Occupation
- PHYSICIAN
- Health Professional
- Yes
Narratives
Additional Manufacturer Narrative · 0
G4 - PREMARKET / 510(K) #: K103751, K110122, K141521.
Description of Event or Problem · 0
IT WAS REPORTED THAT BALLOON RUPTURE OCCURRED. A MUSTANG 7.0 X 150, 75CM WAS ADVANCED FOR DILATATION. DURING TREATMENT, BALLOON BURST AT 25ATM AFTER A MINUTE LATER. THE DEVICE WAS REMOVED USING NORMAL METHOD WITHOUT ISSUE AND THE PROCEDURE WAS COMPLETED WITH A DIFFERENT DEVICE. THERE WAS NO PATIENT INJURY AS A RESULT OF THIS EVENT.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1631017 | MUSTANG? | STENTS, DRAINS AND DILATORS FOR THE BILIARY DUCTS | LIT | BOSTON SCIENTIFIC CORPORATION | H74939171071570 | 0036559896 | 08714729794578 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 53 YR | Male |