MAUDE Adverse Event Report: BOSTON SCIENTIFIC CORPORATION WATCHMAN; SYSTEM, APPENDAGE CLOSURE, LEFT ATRIAL

Model Number	M635WU30060
Medical Device Problem Code	Failure to Seal (4070)
Health Effect - Clinical Code	Stroke/CVA (1770)
Date of Event	02/04/2026
Type of Reportable Event	Serious Injury
Event or Problem Description
It was reported that stroke occurred.A left atrial appendage closure procedure was performed, and a 30mm watchman laa closure device was implanted on (b)(6) 2020.Approximately 6 years later, the patient presented to the hospital after having a stroke.The physician suspected there may be a peri-device leak and is considering using a plug or coil to treat the leak, but this has not yet been confirmed.A transesophageal echocardiogram (tee) was performed and was negative for clot.The patient was restarted on their blood thinners.
Additional Manufacturer Narrative
B3: bsc aware date used as event date unknown.
Additional Manufacturer Narrative
With all the available information, boston scientific (bsc) concludes: device technical analysis: the watchman laa closure device remains implanted; therefore, returned device analysis could not be completed.Media review: the provided medical media was captured during a follow up appointment and does not require further review by either bsc medical safety or watchman medical media smes.Device history record review: a review was completed of the device history records (dhr) for the watchman laa closure device, part # m635wu30060 batch # 0023778898.The device was processed through all normal operational conditions and passed all acceptance activities.The dhr review did not identify any deviations or non-conformances that could have contributed to the event.Labeling review: there was no evidence to suggest that the device was used in a manner inconsistent with the labeling.The watchman laa closure device instructions for use (ifu) lists potential complications, risks and adverse events that may be associated with the use of this device which include implant did not seal and cerebral vascular accident (cva) (medication and imaging required).Risk review: a risk review was completed and confirmed that the events of implant did not seal, and cerebral vascular accident (cva) were defined in the risk documentation.These event types have been accounted for during product risk analysis to support acceptable risk benefit for the product.Investigation conclusion: based on a thorough review of the reported complaint, boston scientific has assigned an investigation conclusion code of known inherent risk of device.
Event or Problem Description
It was reported that stroke occurred.A left atrial appendage closure procedure was performed, and a 30mm watchman laa closure device was implanted on 17-dec-2020.Approximately 6 years later, the patient presented to the hospital after having a stroke.The physician suspected there may be a peri-device leak and is considering using a plug or coil to treat the leak, but this has not yet been confirmed.A transesophageal echocardiogram (tee) was performed and was negative for clot.The patient was restarted on their blood thinners.
Additional Manufacturer Narrative
Section b1 adverse event/product problem: added product problem.With all the available information, boston scientific (bsc) concludes: device technical analysis: the watchman laa closure device remains implanted; therefore, returned device analysis could not be completed.Media review: the provided medical media was captured during a follow up appointment and does not require further review by either bsc medical safety or watchman medical media smes.Device history record review: a review was completed of the device history records (dhr) for the watchman laa closure device, part # m635wu30060; batch # 0023778898.The device was processed through all normal operational conditions and passed all acceptance activities.The dhr review did not identify any deviations or non-conformances that could have contributed to the event.Labeling review: there was no evidence to suggest that the device was used in a manner inconsistent with the labeling.The watchman laa closure device instructions for use (ifu) lists potential complications, risks and adverse events that may be associated with the use of this device which include implant did not seal and cerebral vascular accident (cva) (medication and imaging required).Risk review: a risk review was completed and confirmed that the events of implant did not seal, and cerebral vascular accident (cva) were defined in the risk documentation.These event types have been accounted for during product risk analysis to support acceptable risk benefit for the product.Investigation conclusion: based on a thorough review of the reported complaint, boston scientific has assigned an investigation conclusion code of known inherent risk of device.
Event or Problem Description
It was reported that stroke occurred.A left atrial appendage closure procedure was performed, and a 30 mm watchman laa closure device was implanted on (b)(6) 2020.Approximately six years later, the patient presented to the hospital after having a stroke.The physician suspected there may be a peri-device leak and is considering using a plug or coil to treat the leak, but this has not yet been confirmed.A transesophageal echocardiogram (tee) was performed and was negative for clot.The patient was restarted on their blood thinners.

• Brand Name: WATCHMAN
• Common Device Name: SYSTEM, APPENDAGE CLOSURE, LEFT ATRIAL
• Manufacturer (Section D): BOSTON SCIENTIFIC CORPORATION; 300 boston scientific way; marlborough MA 01752
• Manufacturer (Section G): BOSTON SCIENTIFIC CORPORATION; ballybrit business park; galway ; EI
• Manufacturer Contact: rachel shields ; 4100 hamline ave n; arden hills, MN 55112 ; 6512422111
• MDR Report Key: 24430549
• Report Number: 2124215-2026-10121
• Device Sequence Number: 10297536
• Product Code: NGV
• UDI-Device Identifier: 08714729838258
• UDI-Public: (01)08714729838258(17)220512(10)23778898
• Combination Product (Y/N): N
• Initial Reporter State: IL
• Initial Reporter Country: US
• PMA/510(K) Number: P130013
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Device Implanted Year: 2020
• Serviced by Third Party (Y/N): Unknown
• Reporter Type: Manufacturer
• Report Source: Health Professional,Company Representative
• Initial Reporter Occupation: Physician
• Type of Report: Initial,Followup,Followup
• Report Date (Section B): 05/20/2026

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: Health Professional
• Device Expiration Date: 05/12/2022
• Device Model Number: M635WU30060
• Device Catalogue Number: M635WU30060
• Device Lot Number: 0023778898
• Was Device Available for Evaluation?: No
• Is the Reporter a Health Professional?: Yes
• Type of Report(Section G): Thirty-Day
• Initial Date Received by Manufacturer: 02/04/2026
• Supplement Date Received by Manufacturer: 04/10/2026; 05/08/2026
• Initial Report FDA Received Date: 02/24/2026
• Supplement Report FDA Received Date: 04/15/2026; 05/20/2026
• Date Device Manufactured: 05/13/2019
• 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: Other
• Patient Age: 83 YR
• Patient Sex: Male