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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BOSTON SCIENTIFIC CORPORATION INGEVITY+; Implantable Lead

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BOSTON SCIENTIFIC CORPORATION INGEVITY+; Implantable Lead Back to Search Results
Model Number 7841
Medical Device Problem Codes Difficult to Insert (1316); Material Integrity Problem (2978)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 09/14/2026
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that this right atrial (ra) lead could not be used because the stylet could only be advanced halfway and was unable to reach the distal tip.No lead imaging was performed.This ra lead was replaced with a new lead that was successfully implanted.The cause of the anomaly remained undetermined during the procedure.No adverse patient effects were reported.
 
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Brand Name
INGEVITY+
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 Key50942188
Report Number2124215-2026-51904
Device Sequence Number18826336
Product Code NVN
UDI-Device Identifier00802526604577
Combination Product (Y/N)Y
Initial Reporter StateWA
Initial Reporter CountryUS
PMA/510(K) Number
P150012
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2026
Device Explanted Year2026
Reporter Type Manufacturer
Report Source Health Professional,Company Representative
Initial Reporter Occupation Physician
Type of Report Initial
Report Date (Section B) 09/30/2026
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 Health Professional
Device Model Number7841
Device Catalogue Number7841
Device Lot Number1795369
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 Date09/30/2026
Date Device Manufactured06/18/2026
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 Age56 YR
Patient SexUnknown
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