FDA Adverse Event Malfunction Summary report: N

MUSTANG?

MDR report key: 23443201 · Received October 31, 2025

Report

Report Number
2124215-2025-78676
Event Type
Malfunction
Date Received
October 31, 2025
Date of Event
October 4, 2025
Report Date
November 9, 2025
Manufacturer
BOSTON SCIENTIFIC CORPORATION
Product Code
FGE
UDI-DI
08714729793656
PMA / PMN Number
K141521
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
KS
Reporter Occupation
003

Narratives

Additional Manufacturer Narrative · 0

B5: DESCRIBE EVENT OR PROBLEM: UPDATED TO INCLUDE NEW INFORMATION OBTAINED. 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. GOOD FAITH EFFORT ATTEMPTS WERE MADE TO TRY AND RETRIEVE DEVICE STATUS AND ADDITIONAL DETAILS REGARDING THE REPORTED EVENT, BUT FURTHER INFORMATION WAS UNABLE TO BE OBTAINED.

Description of Event or Problem · 0

IT WAS REPORTED THAT A BALLOON RUPTURE OCCURRED. AN 8.0 X 80, 75 CM MUSTANG BALLOON CATHETER WAS ADVANCED FOR DILATATION. DURING THE PROCEDURE, THE BALLOON RUPTURED. NO ADDITIONAL INFORMATION WAS PROVIDED. IT WAS FURTHER REPORTED THAT THE TARGET LESION, WITH 100% STENOSIS, WAS LOCATED IN THE SEVERELY TORTUOUS AND SEVERELY CALCIFIED ARTERIOVENOUS FISTULA (AVF). DURING THE PROCEDURE, THE BALLOON RUPTURED AFTER 30 SECONDS OF INFLATION. THE PROCEDURE WAS SUCCESSFULLY COMPLETED USING AN ALTERNATE DEVICE. THE PATIENTS CONDITION WAS STABLE AND VERY GOOD POST-PROCEDURE.

Description of Event or Problem · 0

IT WAS REPORTED THAT A BALLOON RUPTURE OCCURRED. AN 8.0 X 80, 75 CM MUSTANG BALLOON CATHETER WAS ADVANCED FOR DILATATION. DURING THE PROCEDURE, THE BALLOON RUPTURED. NO ADDITIONAL INFORMATION WAS PROVIDED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1385770 MUSTANG? STENTS, DRAINS AND DILATORS FOR THE BILIARY DUCTS FGE BOSTON SCIENTIFIC CORPORATION H74939171080870 0036888093 08714729793656

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown