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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BOSTON SCIENTIFIC CORPORATION DYNAGEN? EL ICD VR; IMPLANTABLE CARDIOVERTER DEFIBRILLATOR (ICD)

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BOSTON SCIENTIFIC CORPORATION DYNAGEN? EL ICD VR; IMPLANTABLE CARDIOVERTER DEFIBRILLATOR (ICD) Back to Search Results
Model Number D151
Medical Device Problem Code High impedance (1291)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 04/01/2026
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that this implantable cardioverter defibrillator (icd) exhibited high out of range shock impedances with values greater than 200 ohms in the right ventricular (rv) channel.Technical services (ts) was contacted and provided further evaluation recommendations.Furthermore, it was reported that reprogramming to a different impedance vector was performed and continuous monitoring was going to be provided.This icd remains in service.No adverse patient effects were reported.
 
Additional Manufacturer Narrative
The device was not returned for analysis; therefore, a technical analysis could not be performed.Based on a thorough review of the reported complaint, boston scientific has assigned an investigation conclusion code of known inherent risk of device.
 
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Brand Name
DYNAGEN? EL ICD VR
Common Device Name
IMPLANTABLE CARDIOVERTER DEFIBRILLATOR (ICD)
Manufacturer (Section D)
BOSTON SCIENTIFIC CORPORATION
4100 hamline avenue north
saint paul MN 55112
Manufacturer (Section G)
BOSTON SCIENTIFIC CORPORATION
cashel road
clonmel
EI  
Manufacturer Contact
timothy degroot
4100 hamline avenue north
saint paul, MN 55112
6515826168
MDR Report Key24972071
Report Number2124215-2026-22144
Device Sequence Number10496824
Product Code LWS
UDI-Device Identifier00802526534300
UDI-Public(01)00802526534300(17)250201
Combination Product (Y/N)N
Initial Reporter StateNE
Initial Reporter CountryUS
PMA/510(K) Number
P960040
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2024
Serviced by Third Party (Y/N)Unknown
Reporter Type Manufacturer
Report Source Health Professional
Initial Reporter Occupation Other Health Care Professional
Type of Report Initial
Report Date (Section B) 04/23/2026
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 Date02/01/2025
Device Model NumberD151
Device Catalogue NumberD151
Device Lot Number216463
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 04/03/2026
Initial Report FDA Received Date04/23/2026
Date Device Manufactured02/17/2023
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 Age73 YR
Patient SexMale
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