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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 7842
Medical Device Problem Code 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 brady lead was not successfully implanted due to helix got bent after multiple placement attempts.This brady lead was replaced with a non boston scientific model.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 Key50949522
Report Number2124215-2026-52059
Device Sequence Number21238613
Product Code NVN
UDI-Device Identifier00802526604522
UDI-Public(01)00802526604522(17)280624
Combination Product (Y/N)Y
Initial Reporter StateOH
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 Number7842
Device Catalogue Number7842
Device Lot Number1640557
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 Manufactured06/25/2026
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 Age74 YR
Patient SexUnknown
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