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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BOSTON SCIENTIFIC CORPORATION INGEVITY+; Implantable Lead

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BOSTON SCIENTIFIC CORPORATION INGEVITY+; Implantable Lead Back to Search Results
Model Number 7840
Medical Device Problem Code Device Dislodged or Dislocated (2923)
Health Effect - Clinical Code Twiddlers Syndrome (4563)
Date of Event 08/25/2026
Type of Reportable Event Serious Injury
Event or Problem Description
It was reported that right atrial (ra) lead exhibited lead dislodgement due to suspected twiddling.Fluoroscopy and visual observation confirmed the dislodgement.This ra lead was explanted, replaced with the same model and will be returned for analysis.No additional adverse patient effects were reported.
 
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Brand Name
INGEVITY+
Common Device Name
Implantable Lead
Manufacturer (Section D)
BOSTON SCIENTIFIC CORPORATION
4100 hamline avenue north
saint paul MN 55112
Manufacturer (Section G)
Boston Scientific Corporation
road 698, lot no. 12
dorado PR 00646 -260
PR   00646-2602
Manufacturer Contact
mark mischke
4100 hamline avenue north
saint paul, MN 55112
+1(612)875-7234
MDR Report Key50776545
Report Number2124215-2026-49206
Device Sequence Number9939021
Product Code NVN
UDI-Device Identifier00802526604430
UDI-Public(01)00802526604430(17)270411
Combination Product (Y/N)Y
Initial Reporter StateOH
Initial Reporter CountryUS
PMA/510(K) Number
P150012
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2025
Device Explanted Year2026
Reporter Type Manufacturer
Report Source Health Professional,Company Representative
Initial Reporter Occupation Physician
Type of Report Initial
Report Date (Section B) 09/15/2026
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 Model Number7840
Device Catalogue Number7840
Device Lot Number1148108
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 08/28/2026
Initial Report FDA Received Date09/15/2026
Date Device Manufactured04/11/2025
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 Hospitalization; Required Intervention;
Patient Age48 YR
Patient SexFemale
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