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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 Adverse Event Without Identified Device or Use Problem (2993)
Health Effect - Clinical Code Unspecified Infection (1930)
Date of Event 01/28/2026
Type of Reportable Event Serious Injury
Additional Manufacturer Narrative
This product investigation is still in progress.This report will be updated when product investigation is complete.
 
Event or Problem Description
It was reported that this right ventricular (rv) lead was explanted due to an infection.No additional adverse patient effects were reported.This rv lead has been returned for analysis; however, results of investigation are not available at time of submission of this report.A supplemental report will be submitted once results of investigation become available.
 
Event or Problem Description
It was reported that this right ventricular (rv) lead was explanted due to an infection.No additional adverse patient effects were reported.This rv lead has been returned for analysis.
 
Additional Manufacturer Narrative
Device analysis: this lead was returned.Laboratory analysis did not identify any lead characteristics that would have caused or contributed to the reported clinical observations of infection.Device history record review: a review of the device history record (dhr) was performed.The review of the dhr identified that there were no process related non-conformances, scrap, or rework performed during the production that could explain the event.The reviews ensure each device meets specification prior to release for use.There is no indication the device manufacturing process contributed to the reported complaint.Labeling review: review of labeling determined that the complaint situation was listed in the manual.There was no indication in the complaint that the product was not used in accordance to labeling.The manual was unlikely to be the cause of the reported complaint; translation, wording, or graphics does not require further review.Risk assessment: a risk review was completed and confirmed that the event of infection was defined in the risk documentation.This event type has 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.
 
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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
mark mischke
4100 hamline avenue north
saint paul, MN 55112
+1(612)875-7234
MDR Report Key25001071
Report Number2124215-2026-22576
Device Sequence Number8750495
Product Code NVN
UDI-Device Identifier00802526523335
UDI-Public(01)00802526523335(17)270828
Combination Product (Y/N)Y
Initial Reporter StateOH
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
Initial Reporter Occupation Physician
Type of Report Initial,Followup
Report Date (Section B) 09/11/2026
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 Number7732
Device Catalogue Number7732
Device Lot Number1091225
Was Device Available for Evaluation? Yes
Date Returned to Manufacturer04/06/2026
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 04/06/2026
Supplement Date Received by Manufacturer08/26/2026
Initial Report FDA Received Date04/27/2026
Supplement Report FDA Received Date09/11/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured08/28/2025
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 Age35 YR
Patient SexFemale
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