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

Model Number	7742
Medical Device Problem Code	Insufficient Device Problem Information (3190)
Health Effect - Clinical Code	No Clinical Signs, Symptoms or Conditions (4582)
Date of Event	08/26/2026
Type of Reportable Event	Death
Event or Problem Description
It was reported that this patient was scheduled to undergo a laser lead extraction procedure involving this right ventricular (rv) lead.Technical services (ts) was consulted regarding magnet application instructions and the process for paging a local company representative.Ts provided the requested information; however, no additional details regarding the reason for the procedure were provided.At this time, it had not been confirmed whether the procedure had been performed.This rv lead remains in service.No adverse patient effects were reported.
Event or Problem Description
It was reported that this patient was scheduled to undergo a laser lead extraction procedure involving this right ventricular (rv) lead.Technical services (ts) was consulted regarding magnet application instructions and the process for paging a local company representative.Ts provided the requested information; however, no additional details regarding the reason for the procedure were provided.At this time, it had not been confirmed whether the procedure had been performed.This rv lead 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.
Additional Manufacturer Narrative
Corrected the type of reportable event from death to malfunction since the patient is not deceased.If pertinent information is provided in the future, a supplemental report will be submitted.

• 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 Key: 50885557
• Report Number: 2124215-2026-50936
• Device Sequence Number: 9827134
• Product Code: NVN
• UDI-Device Identifier: 00802526523489
• UDI-Public: (01)00802526523489(17)190121
• Combination Product (Y/N): Y
• Initial Reporter State: FL
• Initial Reporter Country: US
• PMA/510(K) Number: P150012
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Device Implanted Year: 2017
• Reporter Type: Manufacturer
• Report Source: Health Professional
• Initial Reporter Occupation: Physician
• Type of Report: Initial
• Report Date (Section B): 09/24/2026

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 Date: 01/21/2019
• Device Model Number: 7742
• Device Catalogue Number: 7742
• Device Lot Number: 707924
• 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 Date: 09/24/2026
• Date Device Manufactured: 01/21/2017
• 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 Number: 1
• Outcome Attributed to Adverse Event: Death
• Patient Age: 84 YR
• Patient Sex: Male