FDA Adverse Event Injury Summary report: N

INGENIO?

MDR report key: 23200480 · Received October 2, 2025

Report

Report Number
2124215-2025-69728
Event Type
Injury
Date Received
October 2, 2025
Date of Event
September 25, 2025
Report Date
April 23, 2026
Manufacturer
BOSTON SCIENTIFIC CORPORATION
Product Code
LWP
UDI-DI
00802526536786
PMA / PMN Number
N970003
Removal / Correction Number
Z-2016-2021
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
OH, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

A GFE WAS SENT TO REQUEST INFORMATION REGARDING THE DEVICE EXPLANT STATUS, PATIENT OUTCOME, AND DEVICE RETURN, AS WELL AS DETAILS ABOUT THE INITIAL REPORTER, IF A RESPONSE IS RECEIVED, A SUPPLEMENTAL REPORT WILL BE UPLOADED. GFE RESPONSE INDICATED THE DEVICE WAS EXPLANTED; HOWEVER, NO FURTHER INFORMATION WAS OBTAINED REGARDING THE DATE OR ADDITIONAL DETAILS.

Additional Manufacturer Narrative · 0

A GFE WAS SENT TO REQUEST INFORMATION REGARDING THE DEVICE EXPLANT STATUS, PATIENT OUTCOME, AND DEVICE RETURN, AS WELL AS DETAILS ABOUT THE INITIAL REPORTER, IF A RESPONSE IS RECEIVED, A SUPPLEMENTAL REPORT WILL BE UPLOADED. GFE RESPONSE INDICATED THE DEVICE WAS EXPLANTED; HOWEVER, NO FURTHER INFORMATION WAS OBTAINED REGARDING THE DATE OR ADDITIONAL DETAILS. SINCE THE EXPLANT DATE WAS NOT PROVIDED, AN APPROXIMATE DATE HAS BEEN ASSIGNED. ADDITIONAL INFORMATION RECEIVED INDICATED THE EXPLANT DATE.

Additional Manufacturer Narrative · 0

A GFE WAS SENT TO REQUEST INFORMATION REGARDING THE DEVICE EXPLANT STATUS, PATIENT OUTCOME, AND DEVICE RETURN, AS WELL AS DETAILS ABOUT THE INITIAL REPORTER, IF A RESPONSE IS RECEIVED, A SUPPLEMENTAL REPORT WILL BE UPLOADED. GFE RESPONSE INDICATED THE DEVICE WAS EXPLANTED; HOWEVER, NO FURTHER INFORMATION WAS OBTAINED REGARDING THE DATE OR ADDITIONAL DETAILS. SINCE THE EXPLANT DATE WAS NOT PROVIDED, AN APPROXIMATE DATE HAS BEEN ASSIGNED. ADDITIONAL INFORMATION RECEIVED INDICATED THE EXPLANT DATE. UPON RECEIPT AT OUR POST MARKET QUALITY ASSURANCE LABORATORY, THIS DEVICE WAS THOROUGHLY INSPECTED AND ANALYZED. INTERROGATION OF THE DEVICE CONFIRMED IT WAS OPERATING IN SAFETY MODE 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. 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 DEVICE DISPLAYS ERROR MESSAGE 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. BASED ON A THOROUGH REVIEW OF THE REPORTED COMPLAINT, BOSTON SCIENTIFIC HAS ASSIGNED AN INVESTIGATION CONCLUSION CODE OF CAUSE TRACED TO DEVICE DESIGN.

Additional Manufacturer Narrative · 0

A GFE WAS SENT TO REQUEST INFORMATION REGARDING THE DEVICE EXPLANT STATUS, PATIENT OUTCOME, AND DEVICE RETURN, AS WELL AS DETAILS ABOUT THE INITIAL REPORTER, IF A RESPONSE IS RECEIVED, A SUPPLEMENTAL REPORT WILL BE UPLOADED. GFE RESPONSE INDICATED THE DEVICE WAS EXPLANTED; HOWEVER, NO FURTHER INFORMATION WAS OBTAINED REGARDING THE DATE OR ADDITIONAL DETAILS. SINCE THE EXPLANT DATE WAS NOT PROVIDED, AN APPROXIMATE DATE HAS BEEN ASSIGNED.

Additional Manufacturer Narrative · 0

A GFE WAS SENT TO REQUEST INFORMATION REGARDING THE DEVICE EXPLANT STATUS, PATIENT OUTCOME, AND DEVICE RETURN, AS WELL AS DETAILS ABOUT THE INITIAL REPORTER, IF A RESPONSE IS RECEIVED, A SUPPLEMENTAL REPORT WILL BE UPLOADED.

Description of Event or Problem · 0

IT WAS REPORTED THAT THIS PACEMAKER HAD BEEN SWITCHED TO SAFETY MODE. TECHNICAL SERVICES (TS) WAS CONSULTED AND RECOMMENDED DEVICE REPLACEMENT. THIS DEVICE REMAINS IN SERVICE. NO ADVERSE PATIENT EFFECTS WERE REPORTED. ADDITIONAL INFORMATION FROM GFE RESPONSE INDICATED THIS DEVICE WAS EXPLANTED AND SUCCESSFULLY REPLACED; HOWEVER, NO FURTHER INFORMATION WAS OBTAINED REGARDING THE DATE OR ADDITIONAL DETAILS. THIS PRODUCT HAS NOT BEEN RETURNED FOR ANALYSIS AND NO ADDITIONAL ADVERSE PATIENT EFFECTS WERE REPORTED.

Description of Event or Problem · 0

IT WAS REPORTED THAT THIS PACEMAKER HAD BEEN SWITCHED TO SAFETY MODE. TECHNICAL SERVICES (TS) WAS CONSULTED AND RECOMMENDED DEVICE REPLACEMENT. THIS DEVICE REMAINS IN SERVICE. NO ADVERSE PATIENT EFFECTS WERE REPORTED. ADDITIONAL INFORMATION FROM GFE RESPONSE INDICATED THIS DEVICE WAS EXPLANTED AND SUCCESSFULLY REPLACED. THIS PRODUCT HAS NOT BEEN RETURNED FOR ANALYSIS AND NO ADDITIONAL ADVERSE PATIENT EFFECTS WERE REPORTED.

Description of Event or Problem · 0

IT WAS REPORTED THAT THIS PACEMAKER HAD BEEN SWITCHED TO SAFETY MODE. TECHNICAL SERVICES (TS) WAS CONSULTED AND RECOMMENDED DEVICE REPLACEMENT. THIS DEVICE REMAINS IN SERVICE. NO ADVERSE PATIENT EFFECTS WERE REPORTED. ADDITIONAL INFORMATION FROM GOOD FAITH EFFORT (GFE) RESPONSE INDICATED THIS DEVICE WAS EXPLANTED AND SUCCESSFULLY REPLACED. THIS PRODUCT HAS BEEN RETURNED FOR ANALYSIS AND NO ADDITIONAL ADVERSE PATIENT EFFECTS WERE REPORTED.

Description of Event or Problem · 0

IT WAS REPORTED THAT THIS PACEMAKER HAD BEEN SWITCHED TO SAFETY MODE. TECHNICAL SERVICES (TS) WAS CONSULTED AND RECOMMENDED DEVICE REPLACEMENT. THIS DEVICE REMAINS IN SERVICE. NO ADVERSE PATIENT EFFECTS WERE REPORTED. ADDITIONAL INFORMATION FROM GFE RESPONSE INDICATED THIS DEVICE WAS EXPLANTED AND SUCCESSFULLY REPLACED; HOWEVER, NO FURTHER INFORMATION WAS OBTAINED REGARDING THE DATE OR ADDITIONAL DETAILS. THIS PRODUCT HAS NOT BEEN RETURNED FOR ANALYSIS AND NO ADDITIONAL ADVERSE PATIENT EFFECTS WERE REPORTED.

Description of Event or Problem · 0

IT WAS REPORTED THAT THIS PACEMAKER HAD BEEN SWITCHED TO SAFETY MODE. TECHNICAL SERVICES (TS) WAS CONSULTED AND RECOMMENDED DEVICE REPLACEMENT. THIS DEVICE REMAINS IN SERVICE. NO ADVERSE PATIENT EFFECTS WERE REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
529035 INGENIO? IMPLANTABLE PACEMAKER LWP BOSTON SCIENTIFIC CORPORATION K174 114257 00802526536786

Patients

Seq Age Sex Outcome Treatment
1 78 YR Male Required Intervention| H