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U.S. Department of Health and Human Services

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

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BOSTON SCIENTIFIC CORPORATION ENERGEN ICD; IMPLANTABLE PULSE GENERATOR, PACEMAKER (NON-CRT) Back to Search Results
Model Number E140
Device Problems Premature Discharge of Battery (1057); Noise, Audible (3273)
Patient Problem No Clinical Signs, Symptoms or Conditions (4582)
Event Date 10/14/2022
Event Type  Injury  
Manufacturer Narrative
If information is provided in the future, a supplemental report will be issued.
 
Event Description
It was reported that the implantable cardioverter defibrillator (icd) recorded a code 1003 indicative of battery voltage too low for the projected remaining capacity.Data analysis confirmed low voltage fault and found that the power consumption was increasing gradually and appeared to be consistent with the capacitor degradation due to hydrogen gas content.Recommended device replacement or re-assessed within ninety days window.To date, the device remains in service.No adverse patient effects were reported.
 
Event Description
It was reported that the implantable cardioverter defibrillator (icd) recorded a code 1003 indicative of battery voltage too low for the projected remaining capacity.Data analysis confirmed low voltage fault and found that the power consumption was increasing gradually and appeared to be consistent with the capacitor degradation due to hydrogen gas content.Recommended device replacement or re-assessed within ninety days window.To date, the device remains in service.No adverse patient effects were reported.Additional information received indicating that the device was beeping.
 
Manufacturer Narrative
If information is provided in the future, a supplemental report will be issued.
 
Event Description
It was reported that the implantable cardioverter defibrillator (icd) recorded a code 1003 indicative of battery voltage too low for the projected remaining capacity.Data analysis confirmed low voltage fault and found that the power consumption was increasing gradually and appeared to be consistent with the capacitor degradation due to hydrogen gas content.Recommended device replacement or re-assessed within ninety days window.To date, the device remains in service.No adverse patient effects were reported.Additional information received indicating that the device was beeping.Subsequently, this device was explanted and replaced without difficulty.No additional adverse patient effects were reported.
 
Manufacturer Narrative
If information is provided in the future, a supplemental report will be issued.This product has not been returned for analysis.This report will be updated should additional information become available or if analysis is completed.
 
Manufacturer Narrative
If information is provided in the future, a supplemental report will be issued.This product has not been returned for analysis.This report will be updated should additional information become available or if analysis is completed.The returned device was thoroughly inspected and analyzed.Review of device memory confirmed that a low voltage alert (code 1003) was recorded.A high current drain was detected, but the battery still supported full device function.Detailed analysis confirmed the identified high current drain was a result of compromised low voltage capacitors.Low voltage capacitors are used in the device's high voltage charging operation in order to facilitate fast charge times.Investigation has determined that the low voltage capacitors can become compromised due to the presence of excess hydrogen gas within the device case.Malfunction of these capacitors resulted in a high current drain, which was depleting this device's battery faster than normal.
 
Event Description
It was reported that the implantable cardioverter defibrillator (icd) recorded a code 1003 indicative of battery voltage too low for the projected remaining capacity.Data analysis confirmed low voltage fault and found that the power consumption was increasing gradually and appeared to be consistent with the capacitor degradation due to hydrogen gas content.Recommended device replacement or re-assessed within ninety days window.To date, the device remains in service.No adverse patient effects were reported.Additional information received indicating that the device was beeping.Subsequently, this device was explanted and replaced without difficulty.No additional adverse patient effects were reported.
 
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Brand Name
ENERGEN ICD
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 Key15743395
MDR Text Key306180560
Report Number2124215-2022-45669
Device Sequence Number1
Product Code LWP
UDI-Device Identifier00802526480713
UDI-Public00802526480713
Combination Product (y/n)N
Reporter Country CodeUS
PMA/PMN Number
P960040/S235
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Health Professional,Company Representative
Reporter Occupation Other Health Care Professional
Type of Report Initial,Followup,Followup,Followup
Report Date 07/10/2023
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received11/07/2022
Is this an Adverse Event Report? Yes
Is this a Product Problem Report? Yes
Device Operator Lay User/Patient
Device Expiration Date07/21/2016
Device Model NumberE140
Device Catalogue NumberE140
Device Lot Number117423
Was Device Available for Evaluation? Device Returned to Manufacturer
Is the Reporter a Health Professional? Yes
Date Manufacturer Received06/28/2023
Was Device Evaluated by Manufacturer? Yes
Date Device Manufactured07/27/2014
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) Hospitalization; Required Intervention;
Patient Age72 YR
Patient SexMale
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