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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BOSTON SCIENTIFIC CORPORATION DYNAGEN? EL ICD VR; implantable cardioverter defibrillator (ICD)

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BOSTON SCIENTIFIC CORPORATION DYNAGEN? EL ICD VR; implantable cardioverter defibrillator (ICD) Back to Search Results
Model Number D150
Medical Device Problem Code Over-Sensing (1438)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 08/28/2026
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that the healthcare professional (hcp) for the patient with this implantable cardioverter defibrillator (icd) contacted technical services (ts) regarding a large signal observed during a ventricular episode.Ts reviewed the available data and noted that the signal appeared consistent with cardiac contractility modulation (ccm) therapy, which would not be unexpected if a ccm system were implanted.The hcp was unable to confirm whether the patient had a ccm device.Ts further noted that the signal was intermittently oversensed; however, it occurred within the device's blanking period and therefore did not affect timing cycles or result in a device response.This device remains in service.No adverse patient effects were reported.
 
Additional Manufacturer Narrative
If pertinent information is provided in the future, a supplemental report will be submitted.
 
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Brand Name
DYNAGEN? EL ICD VR
Common Device Name
implantable cardioverter defibrillator (ICD)
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 Key50707404
Report Number2124215-2026-48379
Device Sequence Number10057231
Product Code LWS
UDI-Device Identifier00802526534287
UDI-Public(01)00802526534287(17)200129
Combination Product (Y/N)N
Initial Reporter StateSD
Initial Reporter CountryUS
PMA/510(K) Number
P960040
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2018
Reporter Type Manufacturer
Report Source Health Professional
Initial Reporter Occupation Other Health Care Professional
Type of Report Initial
Report Date (Section B) 09/10/2026
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 Date01/29/2020
Device Model NumberD150
Device Catalogue NumberD150
Device Lot Number233140
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 08/31/2026
Initial Report FDA Received Date09/10/2026
Date Device Manufactured02/07/2018
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 Age64 YR
Patient SexMale
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