FDA Adverse Event Malfunction Summary report: N

INGEVITY+

MDR report key: 20989093 · Received December 20, 2024

Report

Report Number
2124215-2024-81029
Event Type
Malfunction
Date Received
December 20, 2024
Date of Event
November 25, 2024
Report Date
November 3, 2025
Manufacturer
BOSTON SCIENTIFIC CORPORATION
Product Code
NVN
UDI-DI
00802526604546
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
IN
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

THE PRODUCT IS EXPECTED TO BE RETURNED FOR ANALYSIS. THIS REPORT WILL BE UPDATED UPON RETURN AND COMPLETION OF ANALYSIS. UPON RECEIPT AT OUR POST MARKET QUALITY ASSURANCE LABORATORY, A THOROUGH EVALUATION OF THE LEAD WAS PERFORMED. TESTING WAS COMPLETED TO ASSESS LEAD ELECTRICAL PERFORMANCE AND INNER INSULATION INTEGRITY. MEASUREMENTS THROUGHOUT THESE TESTS WERE WITHIN NORMAL LIMITS. VISUAL INSPECTION NOTED THE HELIX MECHANISM WAS IN AN EXTENDED POSITION, WITH DRIED BLOOD AND TISSUE IN THE HELIX HOUSING. ADDITIONALLY, THE HELIX WAS NOTED TO BE BENT. A STYLET WAS INSERTED INTO THE LEAD LUMEN WITH NO RESISTANCE. A LABORATORY TECHNICIAN TESTED THE HELIX MECHANISM AND FOUND IT WAS NONFUNCTIONAL, CONFIRMING THE CLINICAL OBSERVATION OF HELIX EXTENSION/RETRACTION DIFFICULTIES. LABORATORY ANALYSIS DID NOT IDENTIFY ANY LEAD CHARACTERISTICS THAT WOULD HAVE CAUSED OR CONTRIBUTED TO THE HIGH PACING THRESHOLDS AND VARIABLE IMPEDANCE MEASUREMENTS THAT WERE OBSERVED DURING THE IMPLANT PROCEDURE.

Additional Manufacturer Narrative · 0

THE PRODUCT IS EXPECTED TO BE RETURNED FOR ANALYSIS. THIS REPORT WILL BE UPDATED UPON RETURN AND COMPLETION OF ANALYSIS.

Description of Event or Problem · 0

IT WAS REPORTED THAT THIS RIGHT VENTRICULAR (RV) LEAD WAS ATTEMPTED TO BE POSITIONED FOR LEFT BUNDLE BRANCH AREA PACING (LBBAP). HIGH PACING THRESHOLDS AND VARIABLE IMPEDANCE MEASUREMENTS BETWEEN 380-1800 OHMS WERE OBSERVED. DURING MULTIPLE POSITIONING ATTEMPTS, THE HELIX STOPPED FUNCTIONING AND COULD NOT BE RETRACTED. A NEW LEAD WAS PROVIDED TO THE PHYSICIAN AND WAS SUCCESSFULLY IMPLANTED IN THE LEFT BUNDLE BRANCH (LBB) AREA. IT WAS SUSPECTED THAT THE POOR THRESHOLD AND IMPEDANCE PARAMETERS OF THE FIRST LEAD WERE DUE TO SCAR TISSUE. NO ADVERSE PATIENT EFFECTS WERE REPORTED. THE ATTEMPTED LEAD WAS EXPECTED TO BE RETURNED FOR ANALYSIS. PRODUCT RETURNED FOR ANALYSIS.

Description of Event or Problem · 0

IT WAS REPORTED THAT THIS RIGHT VENTRICULAR (RV) LEAD WAS ATTEMPTED TO BE POSITIONED FOR LEFT BUNDLE BRANCH AREA PACING (LBBAP). HIGH PACING THRESHOLDS AND VARIABLE IMPEDANCE MEASUREMENTS BETWEEN 380-1800 OHMS WERE OBSERVED. DURING MULTIPLE POSITIONING ATTEMPTS, THE HELIX STOPPED FUNCTIONING AND COULD NOT BE RETRACTED. A NEW LEAD WAS PROVIDED TO THE PHYSICIAN AND WAS SUCCESSFULLY IMPLANTED IN THE LEFT BUNDLE BRANCH (LBB) AREA. IT WAS SUSPECTED THAT THE POOR THRESHOLD AND IMPEDANCE PARAMETERS OF THE FIRST LEAD WERE DUE TO SCAR TISSUE. NO ADVERSE PATIENT EFFECTS WERE REPORTED. THE ATTEMPTED LEAD WAS EXPECTED TO BE RETURNED FOR ANALYSIS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2169921 INGEVITY+ DRUG ELUTING PERMANENT RIGHT VENTRICULAR OR ATRIAL PACEMAKER ELECTRODES NVN BOSTON SCIENTIFIC CORPORATION 7842 1352161 00802526604546

Patients

Seq Age Sex Outcome Treatment
1 64 YR Male