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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BOSTON SCIENTIFIC CORPORATION INOGEN? X4 CRT-D; CARDIAC RESYNCHRONIZATION THERAPY DEFIBRILLATOR

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BOSTON SCIENTIFIC CORPORATION INOGEN? X4 CRT-D; CARDIAC RESYNCHRONIZATION THERAPY DEFIBRILLATOR Back to Search Results
Model Number G148
Medical Device Problem Codes Over-Sensing (1438); Pacing Problem (1439)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 04/30/2026
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that this cardiac resynchronization therapy defibrillator (crt-d) and the non-boston scientific left ventricular (lv) lead exhibited oversensing of atrial signals on the lv channel.The oversensing caused pacing inhibition on the lv lead.Technical services (ts) determined lv sensing was off prior to the oversensing episode.Ts suspected lv sensing was turned on for in-clinic testing and was not turned off after.Ts recommended reprogramming lv sensing off.This crt-d remains in service.No adverse patient effects were reported.
 
Additional Manufacturer Narrative
If pertinent information is provided in the future, a supplemental report will be submitted.
 
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Brand Name
INOGEN? X4 CRT-D
Common Device Name
CARDIAC RESYNCHRONIZATION THERAPY 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 Key25243965
Report Number2124215-2026-27421
Device Sequence Number16085744
Product Code NIK
UDI-Device Identifier00802526534591
UDI-Public(01)00802526534591(17)181210
Combination Product (Y/N)N
Initial Reporter StateMA
Initial Reporter CountryUS
PMA/510(K) Number
P010012
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2017
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) 05/26/2026
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 Date12/10/2018
Device Model NumberG148
Device Catalogue NumberG148
Device Lot Number161341
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 04/30/2026
Supplement Date Received by Manufacturer05/21/2026
Initial Report FDA Received Date05/21/2026
Supplement Report FDA Received Date05/26/2026
Date Device Manufactured12/21/2016
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 SexFemale
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