FDA Adverse Event Injury Summary report: N

ADVANTIO

MDR report key: 22171185 · Received June 9, 2025

Report

Report Number
2124215-2025-37747
Event Type
Injury
Date Received
June 9, 2025
Date of Event
May 31, 2025
Report Date
September 29, 2025
Manufacturer
BOSTON SCIENTIFIC CORPORATION
Product Code
LWP
PMA / PMN Number
N970003/S132
Removal / Correction Number
Z-2016-2021
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
IA, US
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

THIS PRODUCT WAS MANUFACTURED PRIOR TO IMPLEMENTATION OF THE UDI REGULATION AND AS A RESULT, THE COMPLETE UDI IS NOT AVAILABLE. APPLICABLE US PRODUCT DATA HAS BEEN INCLUDED IN THIS REPORT.

Additional Manufacturer Narrative · 0

IF PERTINENT INFORMATION IS PROVIDED IN THE FUTURE, A SUPPLEMENTAL REPORT WILL BE SUBMITTED.

Additional Manufacturer Narrative · 0

THIS PRODUCT WAS MANUFACTURED PRIOR TO IMPLEMENTATION OF THE UDI REGULATION AND AS A RESULT, THE COMPLETE UDI IS NOT AVAILABLE. APPLICABLE US PRODUCT DATA HAS BEEN INCLUDED IN THIS REPORT.

Additional Manufacturer Narrative · 0

THIS PRODUCT WAS MANUFACTURED PRIOR TO IMPLEMENTATION OF THE UDI REGULATION AND AS A RESULT, THE COMPLETE UDI IS NOT AVAILABLE. APPLICABLE US PRODUCT DATA HAS BEEN INCLUDED IN THIS REPORT. UPON RECEIPT AT OUR POST MARKET QUALITY ASSURANCE LABORATORY, THIS DEVICE WAS THOROUGHLY INSPECTED AND ANALYZED. INTERROGATION OF THE DEVICE DETERMINED IT HAD UNDERGONE RESETS AND THAT BRADYCARDIA THERAPY REMAINED AVAILABLE. ENGINEERS DETERMINED THAT THIS DEVICE WAS DEMONSTRATING BEHAVIOR CONSISTENT WITH A HIGH INTERNAL CELL IMPEDANCE WITHIN THE BATTERY. THE HIGH INTERNAL IMPEDANCE RESULTED IN THE SYSTEM RESETS DUE TO TEMPORARY HIGH-POWER CONSUMPTION (DURING TELEMETRY OR OTHER HIGHER POWER DEVICE OPERATIONS) AND SUBSEQUENT REVERSION TO SAFETY MODE OPERATION. BOSTON SCIENTIFIC HAS ISSUED A FIELD SAFETY NOTICE REGARDING INGENIO EXTENDED LIFE (EL) AND CARDIAC RESYNCHRONIZATION THERAPY PACEMAKER (CRT-P) DEVICES THAT MAY EXHIBIT THIS BEHAVIOR. THIS PARTICULAR DEVICE IS INCLUDED IN THE HIGH IMPEDANCE IN INGENIO EXTENDED LIFE (EL) PACEMAKER AND CRT-P ADVISORY POPULATION.

Description of Event or Problem · 0

IT WAS REPORTED THAT THIS PACEMAKER ENTERED SAFETY MODE, WHICH PERMANENTLY LIMITS DEVICE FUNCTION. THIS PACEMAKER IS STILL IN SERVICE. TECHNICAL SERVICES (TS) RECOMMENDED THIS PACEMAKER BE REPLACED SOON. NO ADVERSE PATIENT EFFECTS WERE REPORTED. UPON RECEIVING ADDITIONAL INFORMATION, IT WAS REPORTED THAT THIS PACEMAKER WAS EXPLANTED AND REPLACED. THIS DEVICE IS EXPECTED TO BE RETURNED TO BOSTON SCIENTIFIC FOR ANALYSIS. NO ADDITIONAL ADVERSE PATIENT EFFECTS WERE REPORTED.

Description of Event or Problem · 0

IT WAS REPORTED THAT THIS PACEMAKER ENTERED SAFETY MODE, WHICH PERMANENTLY LIMITS DEVICE FUNCTION. THIS PACEMAKER IS STILL IN SERVICE. TECHNICAL SERVICES (TS) RECOMMENDED THIS PACEMAKER BE REPLACED SOON. NO ADVERSE PATIENT EFFECTS WERE REPORTED.

Description of Event or Problem · 0

IT WAS REPORTED THAT THIS PACEMAKER ENTERED SAFETY MODE, WHICH PERMANENTLY LIMITS DEVICE FUNCTION. THIS PACEMAKER IS STILL IN SERVICE. TECHNICAL SERVICES (TS) RECOMMENDED THIS PACEMAKER BE REPLACED SOON. NO ADVERSE PATIENT EFFECTS WERE REPORTED. UPON RECEIVING ADDITIONAL INFORMATION, IT WAS REPORTED THAT THIS PACEMAKER WAS EXPLANTED AND REPLACED. THIS DEVICE IS EXPECTED TO BE RETURNED TO BOSTON SCIENTIFIC FOR ANALYSIS. NO ADDITIONAL ADVERSE PATIENT EFFECTS WERE REPORTED. UPON RECEIVING ADDITIONAL INFORMATION, THIS PACEMAKER WAS SUSPECTED OF EXHIBITING PREMATURE BATTERY DEPLETION (PBD). NO ADVERSE PATIENT EFFECTS WERE REPORTED.

Description of Event or Problem · 0

IT WAS REPORTED THAT THIS PACEMAKER ENTERED SAFETY MODE, WHICH PERMANENTLY LIMITS DEVICE FUNCTION. THIS PACEMAKER IS STILL IN SERVICE. TECHNICAL SERVICES (TS) RECOMMENDED THIS PACEMAKER BE REPLACED SOON. NO ADVERSE PATIENT EFFECTS WERE REPORTED. UPON RECEIVING ADDITIONAL INFORMATION, IT WAS REPORTED THAT THIS PACEMAKER WAS EXPLANTED AND REPLACED. THIS DEVICE IS EXPECTED TO BE RETURNED TO BOSTON SCIENTIFIC FOR ANALYSIS. NO ADDITIONAL ADVERSE PATIENT EFFECTS WERE REPORTED. UPON RECEIVING ADDITIONAL INFORMATION, THIS PACEMAKER WAS SUSPECTED OF EXHIBITING PREMATURE BATTERY DEPLETION (PBD). NO ADVERSE PATIENT EFFECTS WERE REPORTED. THIS PACEMAKER WAS RETURNED TO BOSTON SCIENTIFIC FOR ANALYSIS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1344649 ADVANTIO IMPLANTABLE PULSE GENERATOR, PACEMAKER (NON-CRT) LWP BOSTON SCIENTIFIC CORPORATION K064 111812

Patients

Seq Age Sex Outcome Treatment
1 89 YR Male Required Intervention| H