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U.S. Department of Health and Human Services

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

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BOSTON SCIENTIFIC CORPORATION INGEVITY? MRI; Implantable Lead Back to Search Results
Model Number 7740
Medical Device Problem Codes Pacing Problem (1439); Under-Sensing (1661)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 09/09/2026
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that this right atrial (ra) lead exhibited undersensing that led to overpacing.Technical services (ts) was consulted and found that the atrial pacing percentage had increased over the previous month.Ts believed the root cause was an incomplete atrioventricular search interval.No adverse patient effects were reported.This ra lead remains 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
INGEVITY? MRI
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 Key50867246
Report Number2124215-2026-50618
Device Sequence Number21160656
Product Code NVN
UDI-Device Identifier00802526523427
UDI-Public(01)00802526523427(17)210909
Combination Product (Y/N)Y
Initial Reporter StateCA
Initial Reporter CountryUS
PMA/510(K) Number
P150012
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2019
Reporter Type Manufacturer
Report Source Health Professional
Initial Reporter Occupation Physician
Type of Report Initial
Report Date (Section B) 09/23/2026
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 Date09/09/2021
Device Model Number7740
Device Catalogue Number7740
Device Lot Number1020237
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 09/09/2026
Initial Report FDA Received Date09/23/2026
Date Device Manufactured09/09/2019
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 Age81 YR
Patient SexFemale
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