MAUDE Adverse Event Report: BOSTON SCIENTIFIC CORPORATION ESSENTIO SR; IMPLANTABLE PULSE GENERATOR

Model Number	L100
Medical Device Problem Code	Premature Discharge of Battery (1057)
Health Effect - Clinical Code	No Clinical Signs, Symptoms or Conditions (4582)
Date of Event	07/16/2024
Type of Reportable Event	Serious Injury
Event or Problem Description
It was reported that this implantable pacemaker exhibited premature battery depletion (pbd).A request was made to have data from this device analyzed.Data analysis confirmed the battery appeared to be depleting more quickly than expected.Also, this device reached elective replacement indicator (eri).Technical services (ts) consultant recommended replacement.This s-icd remains in service.No adverse patient effects were reported.
Event or Problem Description
It was reported that this implantable pacemaker exhibited premature battery depletion (pbd).A request was made to have data from this device analyzed.Data analysis confirmed the battery appeared to be depleting more quickly than expected.Also, this device reached elective replacement indicator (eri).Technical services (ts) consultant recommended replacement.This s-icd remains in service.No adverse patient effects were reported.Additional information indicated that this device was explanted and replaced.No additional adverse patient effects were reported.
Event or Problem Description
It was reported that this implantable pacemaker exhibited premature battery depletion (pbd).A request was made to have data from this device analyzed.Data analysis confirmed the battery appeared to be depleting more quickly than expected.Also, this device reached elective replacement indicator (eri).Technical services (ts) consultant recommended replacement.This s-icd remains in service.No adverse patient effects were reported.Additional information indicated that this device was explanted and replaced.No additional adverse patient effects were reported.
Additional Manufacturer Narrative
Upon receipt at our post market quality assurance laboratory, this device was thoroughly inspected and analyzed.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 capacitors.This resulted in the observed premature battery depletion.It was determined that the capacitors were compromised due to the presence of excess hydrogen in the device case.Boston scientific issued a field safety notice regarding a subset of devices in the accolade pacemaker family that have a potential of exhibiting this behavior.This particular device is included in the hydrogen induced premature depletion advisory population.

• Brand Name: ESSENTIO SR
• Common Device Name: IMPLANTABLE PULSE GENERATOR
• 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: 19991277
• Report Number: 2124215-2024-50791
• Device Sequence Number: 15222830
• Product Code: LWP
• UDI-Device Identifier: 00802526558900
• UDI-Public: 00802526558900
• Combination Product (Y/N): N
• Initial Reporter State: AZ
• Initial Reporter Country: US
• PMA/510(K) Number: N970003/S167
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Device Implanted Year: 2015
• Device Explanted Year: 2024
• Serviced by Third Party (Y/N): Unknown
• Reporter Type: Manufacturer
• Report Source: Health Professional,Company Representative
• Initial Reporter Occupation: Other Health Care Professional
• Remedial Action: Recall,Notification
• Type of Report: Initial,Followup,Followup
• Report Date (Section B): 11/22/2024

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
• Operator of Device: Lay User/Patient
• Device Expiration Date: 06/29/2017
• Device Model Number: L100
• Device Catalogue Number: L100
• Device Lot Number: 704340
• Was Device Available for Evaluation?: Device Returned to Manufacturer
• Is the Reporter a Health Professional?: Yes
• Type of Report(Section G): Thirty-Day
• Initial Date Received by Manufacturer: 07/17/2024
• Supplement Date Received by Manufacturer: 09/04/2024; 10/25/2024
• Initial Report FDA Received Date: 08/15/2024
• Supplement Report FDA Received Date: 10/03/2024; 11/22/2024
• Was Device Evaluated by Manufacturer? (Y/N): Yes
• Date Device Manufactured: 06/29/2015
• Is the Device Labeled for Single Use? (Y/N): Yes
• Is This a Single-Use Device that was Reprocessed and Reused on a Patient? (Y/N): No
• Usage of Device: Initial
• Patient Sequence Number: 1
• Outcome Attributed to Adverse Event: Hospitalization; Required Intervention
• Patient Sex: Female