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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BOSTON SCIENTIFIC CORPORATION INTUA; IMPLANTABLE PACEMAKER

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BOSTON SCIENTIFIC CORPORATION INTUA; IMPLANTABLE PACEMAKER Back to Search Results
Model Number V273
Device Problems Signal Artifact/Noise (1036); Over-Sensing (1438); Pacing Problem (1439); Incorrect, Inadequate or Imprecise Result or Readings (1535)
Patient Problems Syncope/Fainting (4411); Asystole (4442)
Event Date 05/03/2023
Event Type  Injury  
Event Description
It was reported that this implantable pacemaker entered in safety mode, due to this myopotential noise, oversensing and pacing inhibition of over six seconds was observed and the patient experienced a syncope episode.It was decided to explant and replace this device.This device is expected to be returned for analysis.No further adverse patient effects were reported.
 
Event Description
It was reported that this implantable pacemaker entered in safety mode, due to this myopotential noise, oversensing and pacing inhibition of over six seconds was observed and the patient experienced a syncope episode.It was decided to explant and replace this device.This device is expected to be returned for analysis.No further adverse patient effects were reported.
 
Manufacturer Narrative
Upon receipt at our post market quality assurance laboratory, this device was thoroughly inspected and analyzed.Interrogation of the device confirmed it was operating in safety mode due to system resets.It was confirmed that brady therapy remained available.The system resets occurred during a telemetry session and caused the device to enter safety mode.Engineers determined that this device was demonstrating behavior consistent with a high internal cell impedance within the battery.The high internal impedance resulted in the system resets due to temporary high-power consumption related to telemetry attempts and subsequent reversion to safety mode operation.Boston scientific has issued a field safety notice regarding ingenio extended life (el) and cardiac resynchronization therapy pacemaker (crt-p) devices that may exhibit this behavior.This particular device is included in the high impedance in ingenio extended life (el) pacemaker and crt-p advisory population.
 
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Brand Name
INTUA
Type of Device
IMPLANTABLE PACEMAKER
Manufacturer (Section D)
BOSTON SCIENTIFIC CORPORATION
4100 hamline avenue north
saint paul MN 55112
Manufacturer (Section G)
BOSTON SCIENTIFIC CORPORATION
4100 hamline avenue north
saint paul MN 55112 5798
Manufacturer Contact
timothy degroot
4100 hamline avenue north
saint paul, MN 55112
6515826168
MDR Report Key16988830
MDR Text Key315819156
Report Number2124215-2023-25753
Device Sequence Number1
Product Code NKE
UDI-Device Identifier00802526536670
UDI-Public00802526536670
Combination Product (y/n)N
Reporter Country CodeUS
PMA/PMN Number
P030005/S092
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Health Professional
Reporter Occupation Physician
Remedial Action Recall
Type of Report Initial,Followup
Report Date 09/07/2023
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received05/23/2023
Is this an Adverse Event Report? Yes
Is this a Product Problem Report? Yes
Device Operator Lay User/Patient
Device Expiration Date08/10/2015
Device Model NumberV273
Device Catalogue NumberV273
Device Lot Number100535
Was Device Available for Evaluation? Device Returned to Manufacturer
Is the Reporter a Health Professional? Yes
Date Manufacturer Received08/23/2023
Was Device Evaluated by Manufacturer? Yes
Date Device Manufactured08/15/2013
Is the Device Single Use? Yes
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Initial
Patient Sequence Number1
Patient Outcome(s) Required Intervention; Hospitalization;
Patient Age83 YR
Patient SexMale
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