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.
[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
Report Number | 2134265-2020-03546 |
MDR Report Key | 9884056 |
Report Source | COMPANY REPRESENTATIVE,DISTRI |
Date Received | 2020-03-26 |
Date of Report | 2020-03-26 |
Date of Event | 2020-03-05 |
Date Mfgr Received | 2020-03-05 |
Device Manufacturer Date | 2018-09-12 |
Date Added to Maude | 2020-03-26 |
Event Key | 0 |
Report Source Code | Manufacturer report |
Manufacturer Link | Y |
Number of Patients in Event | 0 |
Adverse Event Flag | 3 |
Product Problem Flag | 3 |
Reprocessed and Reused Flag | 3 |
Health Professional | 3 |
Initial Report to FDA | 3 |
Report to FDA | 3 |
Event Location | 3 |
Manufacturer Contact | JAY JOHNSON |
Manufacturer Street | TWO SCIMED PLACE |
Manufacturer City | MAPLE GROVE MN 55311 |
Manufacturer Country | US |
Manufacturer Postal | 55311 |
Manufacturer Phone | 7634942574 |
Manufacturer G1 | BOSTON SCIENTIFIC CORPORATION |
Manufacturer Street | BALLYBRIT BUSINESS PARK |
Manufacturer City | GALWAY |
Manufacturer Country | EI |
Single Use | 3 |
Previous Use Code | 3 |
Event Type | 3 |
Type of Report | 3 |
Brand Name | MUSTANG |
Generic Name | CATHETER, BILIARY, DIAGNOSTIC |
Product Code | FGE |
Date Received | 2020-03-26 |
Model Number | 24674 |
Catalog Number | 24674 |
Lot Number | 0022645526 |
Operator | HEALTH PROFESSIONAL |
Device Availability | N |
Device Eval'ed by Mfgr | R |
Device Sequence No | 1 |
Device Event Key | 0 |
Manufacturer | BOSTON SCIENTIFIC CORPORATION |
Manufacturer Address | TWO SCIMED PLACE MAPLE GROVE MN 55311 US 55311 |
Patient Number | Treatment | Outcome | Date |
---|---|---|---|
1 | 0 | 2020-03-26 |