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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 High impedance (1291); Insufficient Device Problem Information (3190)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 06/02/2026
Type of Reportable Event Serious Injury
Event or Problem Description
It was reported that this right ventricular (rv) lead was surgically abandoned due to unknown product performance anomaly.A new lead with different model was implanted.No additional adverse patient effects were reported.
 
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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
PR   00646-2602
Manufacturer Contact
timothy degroot
4100 hamline avenue north
saint paul, MN 55112
+1(651)582-6168
MDR Report Key25563863
Report Number2124215-2026-32919
Device Sequence Number9995016
Product Code NVN
UDI-Device Identifier00802526523335
UDI-Public(01)00802526523335(17)201114
Combination Product (Y/N)Y
Initial Reporter StateKY
Initial Reporter CountryUS
PMA/510(K) Number
P150012
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2019
Reporter Type Manufacturer
Report Source Health Professional,Company Representative
Initial Reporter Occupation Physician
Type of Report Initial,Followup
Report Date (Section B) 08/17/2026
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? Yes
Operator of Device Lay User/Patient
Device Expiration Date11/14/2020
Device Model Number7732
Device Catalogue Number7732
Device Lot Number690134
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 06/02/2026
Supplement Date Received by Manufacturer07/29/2026
Initial Report FDA Received Date06/19/2026
Supplement Report FDA Received Date08/17/2026
Date Device Manufactured11/14/2018
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
Outcome Attributed to Adverse Event Hospitalization; Required Intervention;
Patient Age77 YR
Patient SexMale
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