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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BOSTON SCIENTIFIC CORPORATION ACCOLADE? EL DR; Implantable Pulse Generator, Pacemaker (Non-Crt)

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BOSTON SCIENTIFIC CORPORATION ACCOLADE? EL DR; Implantable Pulse Generator, Pacemaker (Non-Crt) Back to Search Results
Model Number L321
Medical Device Problem Code High impedance (1291)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 09/01/2026
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that this pacemaker and the right ventricular (rv) lead exhibited a red call doctor icon (rcd).The rcd was recorded due to a high out of range pacing impedance measurement, greater than 3000 ohms.This pacemaker 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
ACCOLADE? EL DR
Common Device Name
Implantable Pulse Generator, Pacemaker (Non-Crt)
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 Key50946995
Report Number2124215-2026-51798
Device Sequence Number9499241
Product Code LWP
UDI-Device Identifier00802526559242
UDI-Public(01)00802526559242(17)190323
Combination Product (Y/N)N
Initial Reporter StateCO
Initial Reporter CountryUS
PMA/510(K) Number
N970003
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2017
Reporter Type Manufacturer
Report Source Other
Initial Reporter Occupation Non-Healthcare 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 Date03/23/2019
Device Model NumberL321
Device Catalogue NumberL321
Device Lot Number719944
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 09/08/2026
Initial Report FDA Received Date09/30/2026
Date Device Manufactured04/18/2017
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 Age86 YR
Patient SexFemale
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