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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BOSTON SCIENTIFIC CORPORATION VISIONIST? CRT-P; Pulse Generator, Pacemaker, Implantable, With Cardiac Resynchronization (Crt-P)

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BOSTON SCIENTIFIC CORPORATION VISIONIST? CRT-P; Pulse Generator, Pacemaker, Implantable, With Cardiac Resynchronization (Crt-P) Back to Search Results
Model Number U225
Medical Device Problem Code Adverse Event Without Identified Device or Use Problem (2993)
Health Effect - Clinical Codes Pocket Erosion (2013); Impaired Healing (2378)
Date of Event 03/01/2026
Type of Reportable Event Serious Injury
Event or Problem Description
It was reported that the patient with this cardiac resynchronization therapy pacemaker (crt-p) experienced impaired healing of pocket site.Reportedly, the site was unable to heal since implant.According to the physician, the patient agrees that the pocket site never really healed.Ultimately, the patient's dog jumped on the chest and ripped the site open.There were no additional adverse patient effects reported.The crt-p was explanted.
 
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Brand Name
VISIONIST? CRT-P
Common Device Name
Pulse Generator, Pacemaker, Implantable, With Cardiac Resynchronization (Crt-P)
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
mark mischke
4100 hamline avenue north
saint paul, MN 55112
+1(612)875-7234
MDR Report Key50601112
Report Number2124215-2026-47050
Device Sequence Number10710614
Product Code NKE
UDI-Device Identifier00802526559426
UDI-Public(01)00802526559426(17)270811
Combination Product (Y/N)N
Initial Reporter StateIL
Initial Reporter CountryUS
PMA/510(K) Number
P030005
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2026
Device Explanted Year2026
Reporter Type Manufacturer
Report Source Health Professional,Company Representative
Initial Reporter Occupation Physician
Type of Report Initial
Report Date (Section B) 09/03/2026
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? No
Operator of Device Lay User/Patient
Device Model NumberU225
Device Catalogue NumberU225
Device Lot Number734128
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 Not provided
Initial Report FDA Received Date09/04/2026
Date Device Manufactured08/22/2025
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 Required Intervention; Hospitalization;
Patient Age67 YR
Patient SexFemale
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