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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BOSTON SCIENTIFIC CORPORATION EASYTRAK 2; IMPLANTABLE LEAD

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BOSTON SCIENTIFIC CORPORATION EASYTRAK 2; IMPLANTABLE LEAD Back to Search Results
Model Number 4518
Medical Device Problem Codes Failure to Capture (1081); High impedance (1291); High Capture Threshold (3266)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 04/07/2026
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that this left ventricular (lv) lead with the cardiac resynchronization therapy defibrillator (crt-d) was exhibiting rising pacing impedances that remained within normal limits and higher capture thresholds.Technical services (ts) also noted possible loss of capture (loc).Ts discussed possible premature ventricular contraction (pvc) and intermittent morphology that fell outside blanking.This lv lead remains in service.No adverse patient effects were reported.
 
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Brand Name
EASYTRAK 2
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 Key25700639
Report Number2124215-2026-35706
Device Sequence Number9747624
Product Code NIK
UDI-Device Identifier00802526417672
UDI-Public(01)00802526417672(17)080714
Combination Product (Y/N)Y
Initial Reporter StateFL
Initial Reporter CountryUS
PMA/510(K) Number
P010012
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2006
Serviced by Third Party (Y/N)Unknown
Reporter Type Manufacturer
Report Source Health Professional
Initial Reporter Occupation Physician
Type of Report Initial
Report Date (Section B) 07/03/2026
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 Date07/14/2008
Device Model Number4518
Device Catalogue Number4518
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 06/03/2026
Initial Report FDA Received Date07/03/2026
Date Device Manufactured07/14/2006
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 Age80 YR
Patient SexMale
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