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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BOSTON SCIENTIFIC NEUROMODULATION CORPORATION Vercise Genus?; stimulator, electrical, implanted, for parkinsonian tremor

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BOSTON SCIENTIFIC NEUROMODULATION CORPORATION Vercise Genus?; stimulator, electrical, implanted, for parkinsonian tremor Back to Search Results
Model Number DB-1216
Medical Device Problem Code Inappropriate or Unexpected Reset (2959)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 05/01/2026
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that the deep brain stimulation (dbs) database analysis performed identified a bluetooth fault code when charging the implantable pulse generator (ipg).Noise from the charging field of the charger interferes with the bluetooth communication chipset, thus causing internal resets where the device stimulation momentarily turns off and then returns to normal operation.The ipg remains implanted in the patient and delivering therapy.
 
Additional Manufacturer Narrative
D2b: additional pro code selection that applies to the indication of this device - nhl, pjs.
 
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Brand Name
Vercise Genus?
Common Device Name
stimulator, electrical, implanted, for parkinsonian tremor
Manufacturer (Section D)
BOSTON SCIENTIFIC NEUROMODULATION CORPORATION
25155 rye canyon loop
valencia CA 91355
Manufacturer (Section G)
Boston Scientific Corporation
cashel road
clonmel E91 T 862
EI   E91 T862
Manufacturer Contact
ricardo amaro castro
25155 rye canyon loop
valencia, CA 91355
+1(320)800-7570
MDR Report Key50225892
Report Number3006630150-2026-05831
Device Sequence Number10296957
Product Code MHY
UDI-Device Identifier08714729985044
UDI-Public(01)08714729985044(17)240329(10)537681
Combination Product (Y/N)N
Initial Reporter StateMA
Initial Reporter CountryUS
PMA/510(K) Number
P150031
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2022
Reporter Type Manufacturer
Report Source Other,Foreign,Health Professional,Company Representative
Remedial Action Notification
Type of Report Initial,Followup
Report Date (Section B) 09/22/2026
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 Date03/29/2024
Device Model NumberDB-1216
Device Catalogue NumberDB-1216
Device Lot Number537681
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 07/22/2026
Supplement Date Received by Manufacturer09/02/2026
Initial Report FDA Received Date08/12/2026
Supplement Report FDA Received Date09/22/2026
Date Device Manufactured03/30/2022
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 Age33 YR
Patient SexMale
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