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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 7735
Medical Device Problem Codes Failure to Capture (1081); Device Dislodged or Dislocated (2923); Insufficient Device Problem Information (3190); High Capture Threshold (3266)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 02/12/2026
Type of Reportable Event Serious Injury
Event or Problem Description
It was reported that this right atrial (ra) lead was explanted due to unknown product performance anomaly.A new lead with different model was implanted.No additional adverse patient effects were reported.
 
Event or Problem Description
It was reported that this right atrial (ra) lead was explanted due to unknown product performance anomaly.A new lead with different model was implanted.No additional adverse patient effects were reported.Additional information indicated that this ra lead had exhibited high pacing threshold due to slack on the lead coming out.Also, the increased threshold rose to no capture.There were no associated patient symptoms.
 
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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
PR   00646-2602
Manufacturer Contact
timothy degroot
4100 hamline avenue north
saint paul, MN 55112
+1(651)582-6168
MDR Report Key24542074
Report Number2124215-2026-12776
Device Sequence Number17558256
Product Code NVN
UDI-Device Identifier00802526523366
UDI-Public(01)00802526523366(17)271021
Combination Product (Y/N)Y
Initial Reporter StateMI
Initial Reporter CountryUS
PMA/510(K) Number
P150012
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2025
Device Explanted Year2026
Reporter Type Manufacturer
Report Source Health Professional,Company Representative
Initial Reporter Occupation Physician
Type of Report Initial,Followup,Followup
Report Date (Section B) 08/13/2026
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? Yes
Operator of Device Lay User/Patient
Device Model Number7735
Device Catalogue Number7735
Device Lot Number1014730
Was Device Available for Evaluation? Yes
Date Returned to Manufacturer03/16/2026
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 02/12/2026
Supplement Date Received by Manufacturer03/12/2026
07/31/2026
Initial Report FDA Received Date03/08/2026
Supplement Report FDA Received Date04/02/2026
08/13/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured10/21/2025
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 Hospitalization; Required Intervention;
Patient Age85 YR
Patient SexMale
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