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U.S. Department of Health and Human Services

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

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BOSTON SCIENTIFIC CORPORATION ACCOLADE? MRI SR; Implantable Pacemaker Back to Search Results
Model Number L310
Medical Device Problem Code Incorrect, Inadequate or Imprecise Result or Readings (1535)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 08/10/2026
Type of Reportable Event Serious Injury
Event or Problem Description
It was reported that this device was operating in safety mode.Technical services (ts) was consulted and found an unknown code and submitted a request for an engineering analysis.Ts recommended device replacement.The device was subsequently explanted, and a new device was successfully implanted.No additional adverse patient effects were reported.This device is no longer in service.
 
Additional Manufacturer Narrative
This product investigation is still in progress.This report will be updated when product investigation is complete.If pertinent information is provided in the future, a supplemental report will be submitted.
 
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Brand Name
ACCOLADE? 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
cashel road
clonmel E91 T 862
EI   E91 T862
Manufacturer Contact
timothy degroot
4100 hamline avenue north
saint paul, MN 55112
+1(651)582-6168
MDR Report Key50266843
Report Number2124215-2026-43893
Device Sequence Number18790606
Product Code LWP
UDI-Device Identifier00802526559204
UDI-Public(01)00802526559204(17)250816
Combination Product (Y/N)N
Initial Reporter StateMA
Initial Reporter CountryUS
PMA/510(K) Number
P150012
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2024
Device Explanted Year2026
Reporter Type Manufacturer
Report Source Company Representative
Initial Reporter Occupation Non-Healthcare Professional
Type of Report Initial
Report Date (Section B) 08/14/2026
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 Date08/16/2025
Device Model NumberL310
Device Catalogue NumberL310
Device Lot Number899569
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 08/10/2026
Initial Report FDA Received Date08/16/2026
Date Device Manufactured09/13/2023
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 SexFemale
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