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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 Insufficient Device Problem Information (3190)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 12/19/2025
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that patient with this right ventricular (rv) lead felt the lead due to device has moved.Boston scientific technical services (ts) referred the patient to clinic.This 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 Key24104924
Report Number2124215-2026-03333
Device Sequence Number10312698
Product Code NVN
UDI-Device Identifier00802526523335
UDI-Public(01)00802526523335(17)250411
Combination Product (Y/N)Y
Initial Reporter StateVA
Initial Reporter CountryUS
PMA/510(K) Number
P150012
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2023
Serviced by Third Party (Y/N)Unknown
Reporter Type Manufacturer
Report Source Consumer
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? Yes
Is this a Product Problem Report? No
Operator of Device Lay User/Patient
Device Expiration Date04/11/2025
Device Model Number7732
Device Catalogue Number7732
Device Lot Number1063146
Was Device Available for Evaluation? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 12/19/2025
Initial Report FDA Received Date01/16/2026
Date Device Manufactured04/11/2023
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 Age80 YR
Patient SexMale
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