FDA Adverse Event Malfunction Summary report: N

MUSTANG?

MDR report key: 23133995 · Received September 24, 2025

Report

Report Number
2124215-2025-67211
Event Type
Malfunction
Date Received
September 24, 2025
Date of Event
September 2, 2025
Report Date
November 21, 2025
Manufacturer
BOSTON SCIENTIFIC CORPORATION
Product Code
FGE
UDI-DI
08714729793489
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. E1: INITIAL REPORTER ADDRESS 1 - (B)(6). G4: PREMARKET / 510(K) # - K141521, K14159.

Additional Manufacturer Narrative · 0

D2B: PRO CODE (PRODUCT CODE) - FGE, LIT. E1: INITIAL REPORTER ADDRESS: (B)(6). G4: PREMARKET / 510(K) # - K141521, K14159. DEVICE EVALUATED BY MFR: THE MUSTANG DEVICE WAS RETURNED TO OUR POST MARKET QUALITY ASSURANCE LABORATORY. A VISUAL EXAMINATION IDENTIFIED THAT THE BALLOON WAS NOT FOLDED WHICH INDICATES THAT THE BALLOON WAS SUBJECTED TO POSITIVE PRESSURE. A LONGITUDINAL TEAR WAS IDENTIFIED IN THE BALLOON MATERIAL. THE TEAR MEASURED APPROXIMATELY 50MM IN LENGTH AND EXTENDED FROM A POSITION 8MM PROXIMAL OF THE PROXIMAL MARKERBAND TO 4MM DISTAL OF THE DISTAL MARKERBAND. A VISUAL EXAMINATION OBSERVED NO DAMAGE TO THE TIP OF THE DEVICE. A VISUAL AND TACTILE EXAMINATION FOUND NO KINKS OR DAMAGE TO THE SHAFT OF THE DEVICE. BOTH MARKERBANDS WERE UNDAMAGED AND PRESENT ON THE SHAFT OF THE DEVICE. THIS CONCLUDES THE PRODUCT ANALYSIS.

Description of Event or Problem · 0

IT WAS REPORTED THAT BALLOON RUPTURE OCCURRED. THE 90% STENOSED TARGET LESION WAS LOCATED IN THE MODERATELY TORTUOUS AND MODERATELY CALCIFIED SUBCLAVIAN VEIN. A 9.0 X 40, 75CM MUSTANG BALLOON CATHETER WAS ADVANCED FOR DILATION. HOWEVER, DURING THE FIRST INFLATION AT 18 ATMOSPHERES FOR 30 SECONDS, THE BALLOON RUPTURED. THE DEVICE WAS REMOVED, AND THE PROCEDURE WAS COMPLETED WITH ANOTHER OF THE SAME 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 90% STENOSED TARGET LESION WAS LOCATED IN THE MODERATELY TORTUOUS AND MODERATELY CALCIFIED SUBCLAVIAN VEIN. A 9.0 X 40, 75CM MUSTANG BALLOON CATHETER WAS ADVANCED FOR DILATION. HOWEVER, DURING THE FIRST INFLATION AT 18 ATMOSPHERES FOR 30 SECONDS, THE BALLOON RUPTURED. THE DEVICE WAS REMOVED, AND THE PROCEDURE WAS COMPLETED WITH ANOTHER OF THE SAME DEVICE. THERE WERE NO PATIENT COMPLICATIONS AS A RESULT OF THIS EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2384205 MUSTANG? STENTS, DRAINS AND DILATORS FOR THE BILIARY DUCTS FGE BOSTON SCIENTIFIC CORPORATION H74939171090470 0035794638 08714729793489

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown