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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BOSTON SCIENTIFIC CORPORATION ACCOLADE? MRI DR; Implantable Pacemaker

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BOSTON SCIENTIFIC CORPORATION ACCOLADE? MRI DR; Implantable Pacemaker Back to Search Results
Model Number L311
Medical Device Problem Code Premature Discharge of Battery (1057)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 07/26/2026
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that this pacemaker recorded a code 1003, indicating the voltage is too low for the projected remaining capacity.A request was made to have data from this device analyzed.Data analysis identified potential high impedance within the battery.Continued monitoring was recommended.No adverse patient effects were reported.This device remains in service at this time.
 
Additional Manufacturer Narrative
This product investigation is still in progress.This report will be updated when product investigation is complete.
 
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Brand Name
ACCOLADE? MRI DR
Common Device Name
Implantable Pacemaker
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 Key50931935
Report Number2124215-2026-51638
Device Sequence Number9734381
Product Code LWP
UDI-Device Identifier00802526559228
UDI-Public(01)00802526559228(17)230830
Combination Product (Y/N)N
Initial Reporter StateCA
Initial Reporter CountryUS
PMA/510(K) Number
P150012
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2021
Reporter Type Manufacturer
Report Source Health Professional,Company Representative
Initial Reporter Occupation Physician
Type of Report Initial
Report Date (Section B) 09/29/2026
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 Date08/30/2023
Device Model NumberL311
Device Catalogue NumberL311
Device Lot Number576092
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 09/10/2026
Initial Report FDA Received Date09/29/2026
Date Device Manufactured09/07/2021
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 Age67 YR
Patient SexMale
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