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U.S. Department of Health and Human Services

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

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BOSTON SCIENTIFIC CORPORATION DYNAGEN? EL ICD DR; IMPLANTABLE CARDIOVERTER DEFIBRILLATOR Back to Search Results
Model Number D153
Medical Device Problem Code Premature Discharge of Battery (1057)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 05/06/2026
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that this implantable cardioverter defibrillator (icd) recorded a code 1003, which states that the voltage is too low for projected remaining capacity.A request was made to have data from this device analyzed.Data analysis confirmed that the power consumption is increasing in a gradual fashion.Device replacement was recommended.This device remains in service at this time.No adverse patient effects were reported.
 
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Brand Name
DYNAGEN? EL ICD DR
Common Device Name
IMPLANTABLE CARDIOVERTER DEFIBRILLATOR
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 Key25236944
Report Number2124215-2026-27353
Device Sequence Number13161084
Product Code LWS
UDI-Device Identifier00802526534829
UDI-Public(01)00802526534829(17)200426
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 Year2019
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,Followup
Report Date (Section B) 06/25/2026
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 Date04/26/2020
Device Model NumberD153
Device Catalogue NumberD153
Device Lot Number212732
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 05/07/2026
Supplement Date Received by Manufacturer06/22/2026
Initial Report FDA Received Date05/20/2026
Supplement Report FDA Received Date06/25/2026
Date Device Manufactured05/11/2018
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
Patient Sequence Number1
Patient Age73 YR
Patient SexMale
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