MAUDE Adverse Event Report: BOSTON SCIENTIFIC CORPORATION ACCOLADE? DR; pacemaker

Model Number	L301
Medical Device Problem Codes	Pacing Problem (1439); Interrogation Problem (4017)
Health Effect - Clinical Codes	Bradycardia (1751); Syncope/Fainting (4411)
Date of Event	08/10/2026
Type of Reportable Event	Serious Injury
Event or Problem Description
It was reported that during a device check, this pacemaker was found to have low battery which prevented device interrogation.It was noted the device was implanted over ten years ago.The patient had a pulse of 32 beats per minute (bpm) and the patient was referred to the emergency department for evaluation and device replacement.Subsequently, this pacemaker was explanted and successfully replaced.No additional adverse patient effects were reported.This pacemaker has not been returned for analysis.
Additional Manufacturer Narrative
This product investigation is still in progress.This report will be updated when product investigation is complete.

• Brand Name: ACCOLADE? DR
• Common Device Name: 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 Key: 50284703
• Report Number: 2124215-2026-44025
• Device Sequence Number: 18580208
• Product Code: LWP
• UDI-Device Identifier: 00802526559174
• UDI-Public: (01)00802526559174(17)170421
• Combination Product (Y/N): N
• Initial Reporter State: PR
• Initial Reporter Country: PR
• PMA/510(K) Number: N970003
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Device Implanted Year: 2015
• Device Explanted Year: 2026
• Reporter Type: Manufacturer
• Report Source: Health Professional
• Initial Reporter Occupation: Physician
• Type of Report: Initial
• Report Date (Section B): 08/17/2026

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 Date: 04/21/2017
• Device Model Number: L301
• Device Catalogue Number: L301
• Device Lot Number: 706668
• 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: 08/10/2026
• Initial Report FDA Received Date: 08/17/2026
• Date Device Manufactured: 04/21/2015
• 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 Number: 1
• Outcome Attributed to Adverse Event: Hospitalization; Required Intervention
• Patient Sex: Male