MAUDE Adverse Event Report: BOSTON SCIENTIFIC CORPORATION ACUITY STEERABLE; PERMANENT DEFIBRILLATOR ELECTRODES

Model Number	4554
Medical Device Problem Codes	Fracture (1260); High impedance (1291)
Health Effect - Clinical Code	No Clinical Signs, Symptoms or Conditions (4582)
Date of Event	08/08/2024
Type of Reportable Event	Serious Injury
Additional Manufacturer Narrative
If pertinent information is provided in the future, a supplemental report will be submitted.
Event or Problem Description
It was reported that this cardiac resynchronization therapy defibrillator (crt-d) and left ventricular (lv) lead exhibited fluctuating lv impedance measurements in august 2024 from a baseline of 700-900 ohms to high out-of-range pace impedance measurements greater than 3,000 ohms.This left ventricular (lv) lead remains in service.No adverse patient effects were reported.
Event or Problem Description
It was reported that this cardiac resynchronization therapy defibrillator (crt-d) and left ventricular (lv) lead exhibited fluctuating lv impedance measurements in august 2024 from a baseline of 700-900 ohms to high out-of-range pace impedance measurements greater than 3,000 ohms.This left ventricular (lv) lead remains in service.No adverse patient effects were reported.Additional information was received that this lv lead was explanted and replaced due to lead fracture.No additional adverse patient effects were reported.The lead was retained by the explanting facility and was likely discarded.
Additional Manufacturer Narrative
If pertinent information is provided in the future, a supplemental report will be submitted.
Event or Problem Description
It was reported that this cardiac resynchronization therapy defibrillator (crt-d) and left ventricular (lv) lead exhibited fluctuating lv impedance measurements in (b)(6) 2024 from a baseline of 700-900 ohms to high out-of-range pace impedance measurements greater than 3,000 ohms.This left ventricular (lv) lead remains in service.No adverse patient effects were reported.Additional information was received that this lv lead was explanted and replaced due to lead fracture.No additional adverse patient effects were reported.The lead was retained by the explanting facility and was likely discarded.
Additional Manufacturer Narrative
If pertinent information is provided in the future, a supplemental report will be submitted.This product has not been returned to boston scientific, and as a result, laboratory analysis could not be conducted.It was reported that this left ventricular (lv) lead exhibited fluctuating lv impedance measurements in (b)(6) 2024 from a baseline of 700-900 ohms to high out-of-range pace impedance measurements greater than 3,000 ohms.Additional information was received that this lv lead was explanted and replaced due to lead fracture.No additional adverse patient effects were reported.The lead was retained by the explanting facility and was likely discarded.A review of the device history record (dhr) was performed.The review of the dhr identified that there were no process related non-conformances, scrap, or rework performed during the production that could explain the event.The reviews ensure each device meets specification prior to release for use.There is no indication the device manufacturing process contributed to the reported complaint.A risk review was completed and confirmed that the event of pacing impedance high out of range was defined in the risk documentation.This event type has been accounted for during product risk analysis to support acceptable risk benefit for the product.Review of labeling determined that the complaint situation was listed in the manual.There was no indication in the complaint that the product was not used in accordance to labeling.The manual was unlikely to be the cause of the reported complaint; translation, wording, or graphics does not require further review.Based on a thorough review of the reported complaint, boston scientific has assigned an investigation conclusion code of known inherent risk of device.

• Brand Name: ACUITY STEERABLE
• Common Device Name: PERMANENT DEFIBRILLATOR ELECTRODES
• Manufacturer (Section D): BOSTON SCIENTIFIC CORPORATION; 4100 hamline avenue north; saint paul MN 55112
• Manufacturer (Section G): BOSTON SCIENTIFIC CORPORATION; road 698, lot no. 12; dorado PR 00646 -260; * 00646-2602
• Manufacturer Contact: timothy degroot ; 4100 hamline avenue north; saint paul, MN 55112 ; 6515826168
• MDR Report Key: 20080736
• Report Number: 2124215-2024-53596
• Device Sequence Number: 20786197
• Product Code: NVY
• Combination Product (Y/N): Y
• Initial Reporter State: PA
• Initial Reporter Country: US
• PMA/510(K) Number: P050046
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Device Implanted Year: 2011
• Device Explanted Year: 2025
• Reporter Type: Manufacturer
• Report Source: Health Professional
• Initial Reporter Occupation: Other Health Care Professional
• Remedial Action: Replace
• Type of Report: Initial,Followup,Followup
• Report Date (Section B): 05/27/2026

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: 09/22/2013
• Device Model Number: 4554
• Device Catalogue Number: 4554
• Device Lot Number: 187968
• Was Device Available for Evaluation?: No
• Is the Reporter a Health Professional?: Yes
• Was the Report Sent to FDA?: No
• Type of Report(Section G): Thirty-Day
• Initial Date Received by Manufacturer: 08/09/2024
• Supplement Date Received by Manufacturer: 09/18/2025; 05/05/2026
• Initial Report FDA Received Date: 08/27/2024
• Supplement Report FDA Received Date: 10/16/2025; 05/28/2026
• Date Device Manufactured: 09/22/2011
• 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: Required Intervention; Hospitalization
• Patient Age: 58 YR
• Patient Sex: Female