MAUDE Adverse Event Report: BOSTON SCIENTIFIC CORPORATION INLIVEN; IMPLANTABLE PULSE GENERATOR, PACEMAKER (NON-CRT)

Model Number W275

Device Problems Premature Discharge of Battery (1057); Battery Problem (2885); Inappropriate or Unexpected Reset (2959)

Patient Problem Dizziness (2194)

Event Date 12/08/2022

Event Type  Injury  

Event Description

It was reported that the battery of this pacemaker decreased from eight months remaining to elective replacement time (ert) status over the course of approximately six months.As the patient is pacing-dependent, they were hospitalized and their device was interrogated, during which the patient experienced dizzy spells.A request was made to have data from this device analyzed.Data analysis confirmed unexpected battery consumption.A power-on-reset fault code was also noted, and a technical services consultant recommended emergent device replacement.Subsequently, the patient underwent a revision procedure, and this device was explanted and replaced without incident.Besides intervention, there were no other adverse patient effects reported.Device return is expected.

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.The system resets occurred during a telemetry session and caused the device to enter safety mode.Engineers determined 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.

Event Description

It was reported that the battery of this pacemaker decreased from eight months remaining to elective replacement time (ert) status over the course of approximately six months.As the patient is pacing-dependent, they were hospitalized and their device was interrogated, during which the patient experienced dizzy spells.A request was made to have data from this device analyzed.Data analysis confirmed unexpected battery consumption.An unexpected power reset was also noted, and a technical services consultant recommended emergent device replacement.Subsequently, the patient underwent a revision procedure, and this device was explanted and replaced without incident.Besides intervention, there were no other adverse patient effects reported.

• Brand Name: INLIVEN
• Type of Device: IMPLANTABLE PULSE GENERATOR, PACEMAKER (NON-CRT)
• Manufacturer (Section D): BOSTON SCIENTIFIC CORPORATION; 4100 hamline avenue north; saint paul MN 55112
• Manufacturer (Section G): BOSTON SCIENTIFIC CORPORATION; cashel road; clonmel ; EI
• Manufacturer Contact: timothy degroot ; 4100 hamline avenue north; saint paul, MN 55112 ; 6515826168
• MDR Report Key: 16095849
• MDR Text Key: 306627532
• Report Number: 2124215-2022-55879
• Device Sequence Number: 1
• Product Code: LWP
• Combination Product (y/n): N
• Reporter Country Code: NL
• Number of Events Reported: 1
• Summary Report (Y/N): N
• Report Source: Manufacturer
• Source Type: Other,Foreign,Company Representative
• Reporter Occupation: Other Health Care Professional
• Remedial Action: Notification
• Type of Report: Initial,Followup
• Report Date: 05/24/2023

1 Device was Involved in the Event

1 Patient was Involved in the Event

• Is this an Adverse Event Report?: Yes
• Is this a Product Problem Report?: Yes
• Device Operator: Lay User/Patient
• Device Expiration Date: 03/10/2016
• Device Model Number: W275
• Device Catalogue Number: W275
• Device Lot Number: 112487
• Was Device Available for Evaluation?: Device Returned to Manufacturer
• Is the Reporter a Health Professional?: Yes
• Initial Date Manufacturer Received: 12/08/2022
• Initial Date FDA Received: 01/04/2023
• Supplement Dates Manufacturer Received: 05/24/2023
• Supplement Dates FDA Received: 05/24/2023
• Was Device Evaluated by Manufacturer?: Yes
• Date Device Manufactured: 03/15/2014
• Is the Device Single Use?: Yes
• Is This a Reprocessed and Reused Single-Use Device?: No
• Type of Device Usage: Initial
• Patient Sequence Number: 1
• Patient Outcome(s): Required Intervention; Hospitalization