FDA Adverse Event Injury Summary report: N

INGEVITY?+

MDR report key: 23312085 · Received October 16, 2025

Report

Report Number
2124215-2025-73852
Event Type
Injury
Date Received
October 16, 2025
Date of Event
September 25, 2025
Report Date
January 23, 2026
Manufacturer
BOSTON SCIENTIFIC CORPORATION
Product Code
NVN
UDI-DI
00802526604522
PMA / PMN Number
P150012
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
PA, US
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

UPON RECEIPT AT OUR POST MARKET QUALITY ASSURANCE LABORATORY, VISUAL INSPECTION OF THE LEAD WAS PERFORMED. LABORATORY TESTING DID NOT IDENTIFY ANY LEAD CHARACTERISTICS THAT WOULD HAVE RESULTED IN THE CLINICAL OBSERVATION OF DISLODGEMENT. NO LEAD ISSUES WERE NOTED THAT WOULD HAVE MADE DISLODGEMENT MORE LIKELY THAN WHAT IS DESCRIBED IN THE INSTRUCTIONS FOR USE AS A KNOWN INHERENT RISK OF THE USE OF THIS PRODUCT. IF PERTINENT INFORMATION IS PROVIDED IN THE FUTURE, A SUPPLEMENTAL REPORT WILL BE SUBMITTED.

Additional Manufacturer Narrative · 0

THIS CORRECTION REPORT WAS SUBMITTED DUE TO CHANGES IN THE H3, DEVICE EVAL BY MANUFACTURER AND H6, EVALUATION CONCLUSION CODES FIELDS. IF PERTINENT INFORMATION IS PROVIDED IN THE FUTURE, A SUPPLEMENTAL REPORT WILL BE SUBMITTED.

Additional Manufacturer Narrative · 0

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

Additional Manufacturer Narrative · 0

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

Description of Event or Problem · 0

IT WAS REPORTED THAT THIS LEFT BUNDLE BRANCH (LBB) LEAD WAS EXPLANTED DUE TO AN UNKNOWN PRODUCT PERFORMANCE ANOMALY. ANOTHER LBB LEAD WAS IMPLANTED TO COMPLETE THE PROCEDURE. ADDITIONAL INFORMATION FROM THE FIELD REPRESENTATIVE PROVIDED APPROXIMATELY 20 MINUTES AFTER THE INITIAL IMPLANT PROCEDURE WAS COMPLETED THIS LBB LEAD DISLODGED. THE PATIENT WAS BROUGHT BACK IN AND ANOTHER LBB LEAD WAS IMPLANTED. THIS LBB HAS BEEN RETURNED AND ANALYSIS COMPLETED. NO ADDITIONAL ADVERSE PATIENT EFFECTS WERE REPORTED.

Description of Event or Problem · 0

IT WAS REPORTED THAT THIS LEFT BUNDLE BRANCH (LBB) LEAD WAS EXPLANTED DUE TO AN UNKNOWN PRODUCT PERFORMANCE ANOMALY. ANOTHER LBB LEAD WAS IMPLANTED TO COMPLETE THE PROCEDURE. ADDITIONAL INFORMATION HAS BEEN REQUESTED BUT WAS NOT PROVIDED AT THIS TIME. THIS LBB HAS BEEN RETURNED BUT ANALYSIS HAS NOT YET BEEN COMPLETED. NO ADDITIONAL ADVERSE PATIENT EFFECTS WERE REPORTED.

Description of Event or Problem · 0

IT WAS REPORTED THAT THIS LEFT BUNDLE BRANCH (LBB) LEAD WAS EXPLANTED DUE TO AN UNKNOWN PRODUCT PERFORMANCE ANOMALY. ANOTHER LBB LEAD WAS IMPLANTED TO COMPLETE THE PROCEDURE. ADDITIONAL INFORMATION FROM THE FIELD REPRESENTATIVE PROVIDED APPROXIMATELY 20 MINUTES AFTER THE INITIAL IMPLANT PROCEDURE WAS COMPLETED THIS LBB LEAD DISLODGED. THE PATIENT WAS BROUGHT BACK IN AND ANOTHER LBB LEAD WAS IMPLANTED. THIS LBB HAS BEEN RETURNED BUT ANALYSIS HAS NOT YET BEEN COMPLETED. NO ADDITIONAL ADVERSE PATIENT EFFECTS WERE REPORTED.

Description of Event or Problem · 0

IT WAS REPORTED THAT THIS LEFT BUNDLE BRANCH (LBB) LEAD WAS EXPLANTED DUE TO AN UNKNOWN PRODUCT PERFORMANCE ANOMALY. ANOTHER LBB LEAD WAS IMPLANTED TO COMPLETE THE PROCEDURE. ADDITIONAL INFORMATION HAS BEEN REQUESTED BUT WAS NOT PROVIDED AT THIS TIME. THIS LBB HAS BEEN RETURNED BUT ANALYSIS HAS NOT YET BEEN COMPLETED. NO ADDITIONAL ADVERSE PATIENT EFFECTS WERE REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2535515 INGEVITY?+ IMPLANTABLE LEAD NVN BOSTON SCIENTIFIC CORPORATION 7842 1520523 00802526604522

Patients

Seq Age Sex Outcome Treatment
1 76 YR Female Required Intervention| H