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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BOSTON SCIENTIFIC CORPORATION ESSENTIO? MRI SR; Implantable Pacemaker

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BOSTON SCIENTIFIC CORPORATION ESSENTIO? MRI SR; Implantable Pacemaker Back to Search Results
Model Number L110
Medical Device Problem Code Premature Discharge of Battery (1057)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 07/02/2026
Type of Reportable Event Serious Injury
Event or Problem Description
It was reported that this pacemaker was explanted due to potential premature battery depletion.This pacemaker was replaced successfully.This device has not been received for investigation.No additional adverse patient effects were reported.
 
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Brand Name
ESSENTIO? MRI SR
Common Device Name
Implantable Pacemaker
Manufacturer (Section D)
BOSTON SCIENTIFIC CORPORATION
4100 hamline avenue north
saint paul MN 55112
Manufacturer (Section G)
Boston Scientific Corporation
4100 hamline avenue north
saint paul MN 55112 -579
Manufacturer Contact
timothy degroot
4100 hamline avenue north
saint paul, MN 55112
+1(651)582-6168
MDR Report Key50093610
Report Number2124215-2026-41121
Device Sequence Number9913336
Product Code LWP
UDI-Device Identifier00802526558948
UDI-Public(01)00802526558948(17)180614
Combination Product (Y/N)N
Initial Reporter StateNE
Initial Reporter CountryUS
PMA/510(K) Number
P150012
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2017
Device Explanted Year2026
Reporter Type Manufacturer
Report Source Health Professional
Initial Reporter Occupation Physician
Type of Report Initial
Report Date (Section B) 07/30/2026
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 Date06/14/2018
Device Model NumberL110
Device Catalogue NumberL110
Device Lot Number718786
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 07/02/2026
Initial Report FDA Received Date07/30/2026
Date Device Manufactured06/24/2016
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
Outcome Attributed to Adverse Event Hospitalization; Required Intervention;
Patient Age45 YR
Patient SexMale
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