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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BOSTON SCIENTIFIC CORPORATION FINELINE II EZ STEROX; IMPLANTABLE LEAD

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BOSTON SCIENTIFIC CORPORATION FINELINE II EZ STEROX; IMPLANTABLE LEAD Back to Search Results
Model Number 4473
Medical Device Problem Code Adverse Event Without Identified Device or Use Problem (2993)
Health Effect - Clinical Code Unspecified Infection (1930)
Date of Event 08/04/2025
Type of Reportable Event Serious Injury
Event or Problem Description
It was reported that this right atrial (ra) lead was part of a system revision due to infection.There was no additional adverse patient effects were reported.This ra lead was explanted.
 
Additional Manufacturer Narrative
Upon receipt at our post market quality assurance laboratory, additional information from product investigation indicates that the allegation against this device was not confirmed.This device was analyzed, passed all the baseline tests and exhibited normal device functions.This supplemental is being filed to capture d9: returned to manufacturer date and investigation results.
 
Event or Problem Description
It was reported that this right atrial (ra) lead was part of a system revision due to infection.There was no additional adverse patient effects were reported.This ra lead was explanted.
 
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Brand Name
FINELINE II EZ STEROX
Common Device Name
IMPLANTABLE LEAD
Manufacturer (Section D)
BOSTON SCIENTIFIC CORPORATION
4100 hamline avenue north
saint paul MN 55112
Manufacturer (Section G)
CPI - DEL CARIBE
guidant puerto rico b. v.
#12, rd. #698
dorado PR 00646
Manufacturer Contact
timothy degroot
4100 hamline avenue north
saint paul, MN 55112
6515826168
MDR Report Key23196901
Report Number2124215-2025-69587
Device Sequence Number9159363
Product Code DTB
UDI-Device Identifier00802526265020
UDI-Public(01)00802526265020(17)040118
Combination Product (Y/N)Y
Initial Reporter StateMA
Initial Reporter CountryUS
PMA/510(K) Number
P960004
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2002
Device Explanted Year2025
Serviced by Third Party (Y/N)Unknown
Reporter Type Manufacturer
Report Source Other
Initial Reporter Occupation Other
Type of Report Initial,Followup
Report Date (Section B) 02/13/2026
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? No
Operator of Device Lay User/Patient
Device Expiration Date01/18/2004
Device Model Number4473
Device Catalogue Number4473
Was Device Available for Evaluation? Device Returned to Manufacturer
Is the Reporter a Health Professional? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 09/10/2025
Supplement Date Received by Manufacturer01/20/2026
Initial Report FDA Received Date10/01/2025
Supplement Report FDA Received Date02/13/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured01/18/2002
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 Number1
Outcome Attributed to Adverse Event Required Intervention; Hospitalization;
Patient Age80 YR
Patient SexMale
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