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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BOSTON SCIENTIFIC CORPORATION RELIANCE 4-FRONT?; Implantable Lead

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BOSTON SCIENTIFIC CORPORATION RELIANCE 4-FRONT?; Implantable Lead Back to Search Results
Model Number 0672
Medical Device Problem Code High impedance (1291)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 08/27/2026
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that the implantable cardioverter defibrillator (icd) and this right ventricular (rv) lead exhibited a high out of range shock impedance measurement at 129 ohms.The shock impedance was back to baseline and was in normal limits.No other lead measurements were out of range.This rv lead remains in service.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.
 
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Brand Name
RELIANCE 4-FRONT?
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 Key50933348
Report Number2124215-2026-51685
Device Sequence Number10759271
Product Code NVY
UDI-Device Identifier00802526592829
UDI-Public(01)00802526592829(17)250906
Combination Product (Y/N)Y
Initial Reporter StateNE
Initial Reporter CountryUS
PMA/510(K) Number
P910073
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2023
Reporter Type Manufacturer
Report Source Health Professional
Initial Reporter Occupation Other Health Care Professional
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 Date09/06/2025
Device Model Number0672
Device Catalogue Number0672
Device Lot Number227506
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 09/14/2026
Initial Report FDA Received Date09/29/2026
Date Device Manufactured09/07/2023
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 Age63 YR
Patient SexFemale
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