FDA Adverse Event Injury Summary report: N

NUCLEUS CI422 COCHLEAR IMPLANT WITH SLIM STRAIGHT ELECTRODE

MDR report key: 10031583 · Received May 7, 2020

Report

Report Number
6000034-2020-01288
Event Type
Injury
Date Received
May 7, 2020
Report Date
September 25, 2020
Manufacturer
COCHLEAR LTD
Product Code
MCM
UDI-DI
09321502025706
PMA / PMN Number
P970051
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
TU
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 0

THE DEVICE ANALYSIS REPORT IS ATTACHED. THIS REPORT IS SUBMITTED ON OCTOBER 16, 2020.

Additional Manufacturer Narrative · 0

THE DATE OF AWARENESS FOR THE INITIAL REPORT IS APRIL 16, 2020. THIS REPORT IS SUBMITTED ON MAY 26, 2020.

Description of Event or Problem · 1

PER THE CLINIC, THE DEVICE WAS EXPLANTED (DATE NOT REPORTED) DUE TO EXTRUSION OF DEVICE. THE PATIENT WAS REIMPLANTED WITH A NEW DEVICE (DATE NOT REPORTED).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
498337 NUCLEUS CI422 COCHLEAR IMPLANT WITH SLIM STRAIGHT ELECTRODE NUCLEUS 24 COCHLEAR IMPLANT SYSTEM MCM COCHLEAR LTD CI422 N/A 09321502025706

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention