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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BOSTON SCIENTIFIC CORPORATION INGEVITY? MRI; IMPLANTABLE LEAD

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BOSTON SCIENTIFIC CORPORATION INGEVITY? MRI; IMPLANTABLE LEAD Back to Search Results
Model Number 7732
Medical Device Problem Code High impedance (1291)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 12/23/2025
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that this right ventricular (rv) lead triggered a lead safety switch (lss) due to high out of range pacing impedance measurements of 2146ohms.Technical services (ts) was contacted and also noted spikes in the impedance measurements.Follow up with the physician was recommended.This rv lead remains in service.No adverse patient effects were reported.
 
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Brand Name
INGEVITY? MRI
Common Device Name
IMPLANTABLE LEAD
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 Key24099940
Report Number2124215-2026-03275
Device Sequence Number10340956
Product Code NVN
UDI-Device Identifier00802526523335
UDI-Public(01)00802526523335(17)200612
Combination Product (Y/N)Y
Initial Reporter StateMA
Initial Reporter CountryUS
PMA/510(K) Number
P150012
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2019
Serviced by Third Party (Y/N)Unknown
Reporter Type Manufacturer
Report Source Company Representative
Initial Reporter Occupation Other
Type of Report Initial
Report Date (Section B) 01/16/2026
1 Device was Involved in the Event
1 Patient was Involved in the Event
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Operator of Device Lay User/Patient
Device Expiration Date06/12/2020
Device Model Number7732
Device Catalogue Number7732
Device Lot Number680630
Was Device Available for Evaluation? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 12/24/2025
Initial Report FDA Received Date01/16/2026
Date Device Manufactured06/12/2018
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
Patient SexMale
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