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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 High impedance (1291)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 04/08/2026
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that this pacemaker system triggered a lead safety switch (lss) due to high out of range pacing impedance measurements of 2001 ohms in the right ventricular (rv) channel.The patient contacted technical services (ts) since the device recorded an alert.This rv lead remains in service.No adverse patient effects were reported.
 
Additional Manufacturer Narrative
The device remains in service; 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
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 Key25009931
Report Number2124215-2026-22738
Device Sequence Number18657565
Product Code NVN
UDI-Device Identifier00802526523335
UDI-Public(01)00802526523335(17)250717
Combination Product (Y/N)Y
Initial Reporter StateCA
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) 04/27/2026
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 Date07/17/2025
Device Model Number7732
Device Catalogue Number7732
Device Lot Number1064966
Was Device Available for Evaluation? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 04/10/2026
Initial Report FDA Received Date04/27/2026
Date Device Manufactured07/18/2023
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 Age68 YR
Patient SexMale
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