MUSTANG 24674

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a company representative,distri report with the FDA on 2020-03-26 for MUSTANG 24674 manufactured by Boston Scientific Corporation.

Event Text Entries

[185209017] It was reported that balloon rupture occurred. Vascular access was obtained via contralateral approach. The 95% stenosed target lesion was located in the moderately tortuous and severely calcified right common iliac artery to external iliac artery. After a guidewire crossed the lesion, intravascular ultrasound was performed. A 8. 0mmx20mmx135cm sterling balloon catheter was advanced for pre-dilatation. However, upon inflation at 8 atmospheres, the balloon ruptured. The device was replaced with a 8. 0 x 40, 40cm mustang balloon catheter but it also ruptured during inflation at 10 atmospheres. Subsequently, three epic stents were implanted and post-dilatation was performed with a 8x60 sterling balloon catheter. The procedure was completed and no patient complications were reported.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number2134265-2020-03546
MDR Report Key9884056
Report SourceCOMPANY REPRESENTATIVE,DISTRI
Date Received2020-03-26
Date of Report2020-03-26
Date of Event2020-03-05
Date Mfgr Received2020-03-05
Device Manufacturer Date2018-09-12
Date Added to Maude2020-03-26
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer ContactJAY JOHNSON
Manufacturer StreetTWO SCIMED PLACE
Manufacturer CityMAPLE GROVE MN 55311
Manufacturer CountryUS
Manufacturer Postal55311
Manufacturer Phone7634942574
Manufacturer G1BOSTON SCIENTIFIC CORPORATION
Manufacturer StreetBALLYBRIT BUSINESS PARK
Manufacturer CityGALWAY
Manufacturer CountryEI
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameMUSTANG
Generic NameCATHETER, BILIARY, DIAGNOSTIC
Product CodeFGE
Date Received2020-03-26
Model Number24674
Catalog Number24674
Lot Number0022645526
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerBOSTON SCIENTIFIC CORPORATION
Manufacturer AddressTWO SCIMED PLACE MAPLE GROVE MN 55311 US 55311


Patients

Patient NumberTreatmentOutcomeDate
10 2020-03-26

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