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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BOSTON SCIENTIFIC CORPORATION INOGEN? EL ICD DR; implantable cardioverter defibrillator

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BOSTON SCIENTIFIC CORPORATION INOGEN? EL ICD DR; implantable cardioverter defibrillator Back to Search Results
Model Number D142
Medical Device Problem Code Premature Discharge of Battery (1057)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 06/06/2026
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that this implantable cardioverter defibrillator (icd) recorded a code 1003 indicative of battery voltage too low for the projected remaining capacity.A request was made to have data from this device analyzed.Data analysis confirmed that this device power consumption was increasing in a gradual fashion.Device replacement was recommended.To date, this device remains in service.No adverse patient effects were reported.
 
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Brand Name
INOGEN? 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
+1(651)582-6168
MDR Report Key25708320
Report Number2124215-2026-35872
Device Sequence Number16113165
Product Code LWS
UDI-Device Identifier00802526534249
UDI-Public(01)00802526534249(17)200219
Combination Product (Y/N)N
Initial Reporter StateKY
Initial Reporter CountryUS
PMA/510(K) Number
P960040
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2018
Reporter Type Manufacturer
Report Source Health Professional
Initial Reporter Occupation Other Health Care Professional
Type of Report Initial,Followup
Report Date (Section B) 08/13/2026
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 Date02/19/2020
Device Model NumberD142
Device Catalogue NumberD142
Device Lot Number542756
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 06/19/2026
Supplement Date Received by Manufacturer08/12/2026
Initial Report FDA Received Date07/03/2026
Supplement Report FDA Received Date08/14/2026
Date Device Manufactured03/12/2018
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 Age70 YR
Patient SexMale
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