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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BOSTON SCIENTIFIC CORPORATION RESONATE? HF CRT-D; Cardiac Resynchronization Therapy Defibrillator

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BOSTON SCIENTIFIC CORPORATION RESONATE? HF CRT-D; Cardiac Resynchronization Therapy Defibrillator Back to Search Results
Model Number G547
Medical Device Problem Code Premature Discharge of Battery (1057)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 09/22/2026
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that this cardiac resynchronization therapy defibrillator (crt-d) recorded a code 1003 indicative of battery voltage too low for the projected remaining capacity.A request was made to have data from this device analyzed.Data analysis low voltage fault and that this device power consumption was increasing in a gradual fashion.Device replacement was recommended.To date, this device remains in service.No adverse patient effects were reported.
 
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Brand Name
RESONATE? HF CRT-D
Common Device Name
Cardiac Resynchronization Therapy Defibrillator
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 Key50943564
Report Number2124215-2026-51917
Device Sequence Number9499529
Product Code NIK
UDI-Device Identifier00802526589744
Combination Product (Y/N)N
Initial Reporter StateAL
Initial Reporter CountryUS
PMA/510(K) Number
P010012
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2022
Reporter Type Manufacturer
Report Source Health Professional
Initial Reporter Occupation Other Health Care Professional
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 Lay User/Patient
Device Expiration Date11/27/2024
Device Model NumberG547
Device Catalogue NumberG547
Device Lot Number295994
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 09/22/2026
Initial Report FDA Received Date09/30/2026
Date Device Manufactured12/02/2022
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 Age54 YR
Patient SexMale
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