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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BOSTON SCIENTIFIC CORPORATION FLEXTEND; IMPLANTABLE LEAD

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BOSTON SCIENTIFIC CORPORATION FLEXTEND; IMPLANTABLE LEAD Back to Search Results
Model Number 4086
Medical Device Problem Code Adverse Event Without Identified Device or Use Problem (2993)
Health Effect - Clinical Codes Erosion (1750); Unspecified Infection (1930); Inflammation (1932); Swelling/ Edema (4577)
Date of Event 05/19/2026
Type of Reportable Event Serious Injury
Event or Problem Description
It was reported that this right atrial (ra) lead was part of a system revision due to erosion and infection.The patient experienced edema, inflammation and swelling.There were no additional adverse patient effects reported.The ra lead was cut from the terminal pin, and the lead body remains implanted and inactive.
 
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Brand Name
FLEXTEND
Common Device Name
IMPLANTABLE LEAD
Manufacturer (Section D)
BOSTON SCIENTIFIC CORPORATION
4100 hamline avenue north
saint paul MN 55112
Manufacturer (Section G)
CPI - DEL CARIBE
guidant puerto rico b. v.
#12, rd. #698
dorado PR 00646
Manufacturer Contact
timothy degroot
4100 hamline avenue north
saint paul, MN 55112
6515826168
MDR Report Key25446917
Report Number2124215-2026-30775
Device Sequence Number9533573
Product Code DTB
UDI-Device Identifier00802526397721
UDI-Public(01)00802526397721(17)090116
Combination Product (Y/N)Y
Initial Reporter StateSC
Initial Reporter CountryUS
PMA/510(K) Number
P960006
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2008
Serviced by Third Party (Y/N)Unknown
Reporter Type Manufacturer
Report Source Health Professional,Company Representative
Initial Reporter Occupation Physician
Type of Report Initial
Report Date (Section B) 06/09/2026
1 Device was Involved in the Event
1 Patient was Involved in the Event
Is this an Adverse Event Report? Yes
Is this a Product Problem Report? No
Operator of Device Lay User/Patient
Device Expiration Date01/16/2009
Device Model Number4086
Device Catalogue Number4086
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 05/20/2026
Initial Report FDA Received Date06/09/2026
Date Device Manufactured01/16/2007
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
Outcome Attributed to Adverse Event Required Intervention; Hospitalization;
Patient Age71 YR
Patient SexFemale
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