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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 7741
Medical Device Problem Codes Over-Sensing (1438); Failure to Read Input Signal (1581); High Capture Threshold (3266)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 08/26/2026
Type of Reportable Event Serious Injury
Event or Problem Description
It was reported that this right atrial (ra) lead was surgically abandoned due to unknown product performance anomaly and a new ra lead with different model was implanted.No additional adverse patient effects were reported.Additional information indicated that this ra lead exhibited a high capture threshold and low p waves.Additionally, the lead was oversensing, prompting the physician to implant a new lead.No adverse patient effects were reported.
 
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 Key50868051
Report Number2124215-2026-50632
Device Sequence Number13067229
Product Code NVN
UDI-Device Identifier00802526523458
UDI-Public(01)00802526523458(17)200126
Combination Product (Y/N)Y
Initial Reporter StateMS
Initial Reporter CountryUS
PMA/510(K) Number
P150012
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2018
Reporter Type Manufacturer
Report Source Health Professional,Company Representative
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? Yes
Is this a Product Problem Report? Yes
Operator of Device Lay User/Patient
Device Expiration Date01/26/2020
Device Model Number7741
Device Catalogue Number7741
Device Lot Number861801
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 08/26/2026
Initial Report FDA Received Date09/23/2026
Date Device Manufactured01/26/2018
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
Outcome Attributed to Adverse Event Hospitalization; Required Intervention;
Patient Age70 YR
Patient SexFemale
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