FDA Adverse Event Injury Summary report: N

RESONATE X4 CRT-D

MDR report key: 22572349 · Received July 22, 2025

Report

Report Number
2124215-2025-49367
Event Type
Injury
Date Received
July 22, 2025
Date of Event
July 18, 2025
Report Date
March 25, 2026
Manufacturer
BOSTON SCIENTIFIC CORPORATION
Product Code
NIK
UDI-DI
00802526603938
PMA / PMN Number
P010012/S436
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
AS
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

CORRECTION TO FIELD H6: PATIENT CODES. UPDATED TO E060110 VENTRICULAR FIBRILLATION.

Additional Manufacturer Narrative · 0

THIS PRODUCT HAS NOT BEEN RETURNED FOR ANALYSIS AS IT REMAINS IN SERVICE. SINCE THE REPORTED ISSUES ARE COVERED BY THE INSTRUCTIONS FOR USE, IT CAN BE CONCLUDED THAT EXPECTED OR WELL-UNDERSTOOD FACTORS MOST PROBABLY CONTRIBUTED TO THE EVENT. THIS REPORT WILL BE UPDATED SHOULD ADDITIONAL INFORMATION BECOME AVAILABLE OR IF ANALYSIS IS COMPLETED. A REVIEW OF THE DEVICE HISTORY RECORD (DHR) WAS PERFORMED. THE REVIEW OF THE DHR IDENTIFIED THAT THERE WERE NO PROCESS RELATED NON-CONFORMANCES, SCRAP, OR REWORK PERFORMED DURING THE PRODUCTION THAT COULD EXPLAIN THE EVENT. THE REVIEWS ENSURE EACH DEVICE MEETS SPECIFICATION PRIOR TO RELEASE FOR USE. THERE IS NO INDICATION THE DEVICE MANUFACTURING PROCESS CONTRIBUTED TO THE REPORTED COMPLAINT. A RISK REVIEW WAS COMPLETED AND CONFIRMED THAT THE EVENT OF RHYTHM ACCELERATION WAS DEFINED IN THE RISK DOCUMENTATION. THIS EVENT TYPE HAS BEEN ACCOUNTED FOR DURING PRODUCT RISK ANALYSIS TO SUPPORT ACCEPTABLE RISK BENEFIT FOR THE PRODUCT. REVIEW OF LABELING DETERMINED THAT THE COMPLAINT SITUATION WAS LISTED IN THE MANUAL. THERE WAS NO INDICATION IN THE COMPLAINT THAT THE PRODUCT WAS NOT USED IN ACCORDANCE TO LABELING. THE MANUAL WAS UNLIKELY TO BE THE CAUSE OF THE REPORTED COMPLAINT; TRANSLATION, WORDING, OR GRAPHICS DOES NOT REQUIRE FURTHER REVIEW. THIS DEVICE REMAINS IMPLANTED AND IN-SERVICE AND SO HAS NOT BEEN RETURNED. AS SUCH, PHYSICAL ANALYSIS HAS NOT BEEN CONDUCTED IN OUR LABORATORY. HOWEVER, ANALYSIS OF THE AVAILABLE INFORMATION DETERMINED THAT THE RHYTHM ACCELERATION AND FAILURE TO CAPTURE ARE A KNOWN INHERENT RISK WITH USE OF THIS PRODUCT.

Description of Event or Problem · 0

IT WAS REPORTED THAT DURING AN EPISODE OF VENTRICULAR TACHYCARDIA (VT), ANTI-TACHYCARDIA PACING (ATP) WAS DELIVERED BY THE CARDIAC RESYNCHRONIZATION THERAPY DEFIBRILLATOR (CRT-D). NON-CAPTURE WAS OBSERVED AND THE ARRHYTHMIA INTERVALS ACCELERATED INTO THE VENTRICULAR FIBRILLATION (VF) ZONE. THE CRT-D DELIVERED A SHOCK WHICH SUCCESSFULLY CONVERTED THE ARRHYTHMIA. THE CRT-D SYSTEM REMAINS IN SERVICE. NO ADDITIONAL ADVERSE PATIENT EFFECTS WERE REPORTED.

Description of Event or Problem · 0

IT WAS REPORTED THAT DURING AN EPISODE OF VENTRICULAR TACHYCARDIA (VT), ANTI-TACHYCARDIA PACING (ATP) WAS DELIVERED BY THE CARDIAC RESYNCHRONIZATION THERAPY DEFIBRILLATOR (CRT-D). NON-CAPTURE WAS OBSERVED AND THE ARRHYTHMIA INTERVALS ACCELERATED INTO THE VENTRICULAR FIBRILLATION (VF) ZONE. THE CRT-D DELIVERED A SHOCK WHICH SUCCESSFULLY CONVERTED THE ARRHYTHMIA. THE CRT-D SYSTEM REMAINS IN SERVICE. NO ADDITIONAL ADVERSE PATIENT EFFECTS WERE REPORTED.

Description of Event or Problem · 0

IT WAS REPORTED THAT DURING AN EPISODE OF VENTRICULAR TACHYCARDIA (VT), ANTI-TACHYCARDIA PACING (ATP) WAS DELIVERED BY THE CARDIAC RESYNCHRONIZATION THERAPY DEFIBRILLATOR (CRT-D). NON-CAPTURE WAS OBSERVED AND THE ARRHYTHMIA INTERVALS ACCELERATED INTO THE VENTRICULAR FIBRILLATION (VF) ZONE. THE CRT-D DELIVERED A SHOCK WHICH SUCCESSFULLY CONVERTED THE ARRHYTHMIA. THE CRT-D SYSTEM REMAINS IN SERVICE. NO ADDITIONAL ADVERSE PATIENT EFFECTS WERE REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1938370 RESONATE X4 CRT-D IMPLANTABLE DEVICE NIK BOSTON SCIENTIFIC CORPORATION G447 328221 00802526603938

Patients

Seq Age Sex Outcome Treatment
1 68 YR Unknown Life Threatening