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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BOSTON SCIENTIFIC CORPORATION ACCOLADE? SR; Pacemaker

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BOSTON SCIENTIFIC CORPORATION ACCOLADE? SR; Pacemaker Back to Search Results
Model Number L300
Medical Device Problem Codes Signal Artifact/Noise (1036); Premature Discharge of Battery (1057); High impedance (1291); Over-Sensing (1438)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 04/20/2026
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that this device recorded a code 1003, indicating the voltage is too low for the projected remaining capacity.A request was made to have data from this device analyzed.Data analysis identified potential high impedance within the battery.Continued monitoring was recommended.The device still remains in service.No adverse patient effects were reported.
 
Additional Manufacturer Narrative
This product investigation is still in progress.This report will be updated when product investigation is complete.
 
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Brand Name
ACCOLADE? SR
Common Device Name
Pacemaker
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
mark mischke
4100 hamline avenue north
saint paul, MN 55112
+1(612)875-7234
MDR Report Key25073473
Report Number2124215-2026-24056
Device Sequence Number10357763
Product Code LWP
UDI-Device Identifier00802526559150
UDI-Public(01)00802526559150(17)200719
Combination Product (Y/N)N
Initial Reporter StateIL
Initial Reporter CountryUS
PMA/510(K) Number
N970003
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2019
Reporter Type Manufacturer
Report Source Health Professional
Initial Reporter Occupation Other Health Care Professional
Remedial Action Notification
Type of Report Initial,Followup,Followup
Report Date (Section B) 09/08/2026
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 Date07/19/2020
Device Model NumberL300
Device Catalogue NumberL300
Device Lot Number723118
Was Device Available for Evaluation? No
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 04/22/2026
Supplement Date Received by Manufacturer06/09/2026
09/08/2026
Initial Report FDA Received Date05/04/2026
Supplement Report FDA Received Date06/17/2026
09/08/2026
Date Device Manufactured08/17/2018
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
If action reported to FDA under 21 USC 360i(g), list
FDA-assigned Recall Number or include a statement
2124215-03/18/26-001-C
Patient Sequence Number1
Patient Age73 YR
Patient SexFemale
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