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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 Code Insufficient Device Problem Information (3190)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 09/02/2026
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that an alert was displayed for this right atrial (ra) lead.No specific details for the alert are available at this time.This ra lead remains in service.No adverse patient effects were reported.
 
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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 Key50933793
Report Number2124215-2026-51697
Device Sequence Number21519873
Product Code NVN
UDI-Device Identifier00802526523458
UDI-Public(01)00802526523458(17)210626
Combination Product (Y/N)N
Initial Reporter StateKY
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 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 Date06/26/2021
Device Model Number7741
Device Catalogue Number7741
Device Lot Number1048082
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 09/15/2026
Initial Report FDA Received Date09/29/2026
Date Device Manufactured06/26/2019
Is the Device Labeled for Single Use? (Y/N) Yes
Usage of Device Initial
Patient Sequence Number1
Patient Age79 YR
Patient SexFemale
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