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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 Codes Failure to Capture (1081); High Capture Threshold (3266)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 04/17/2026
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that this right ventricular (rv) lead showed a sudden increase in pacing threshold values.The output is programmed to trend but at a rv automatic threshold test, loss of capture was observed at a lower than programmed output value.The patient is lowly rv paced; therefore health care professional will continue monitoring the patient.The rv lead 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
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 Key25197884
Report Number2124215-2026-26588
Device Sequence Number8816773
Product Code NVN
UDI-Device Identifier00802526523335
UDI-Public(01)00802526523335(17)241205
Combination Product (Y/N)Y
Initial Reporter StateCT
Initial Reporter CountryUS
PMA/510(K) Number
P150012
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) 05/18/2026
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 Date12/05/2024
Device Model Number7732
Device Catalogue Number7732
Device Lot Number1057269
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 04/27/2026
Initial Report FDA Received Date05/18/2026
Date Device Manufactured12/05/2022
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 Age84 YR
Patient SexMale
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