FDA Adverse Event Injury Summary report: N

NUCLEUS 22 CHANNEL COCHLEAR IMPLANT SYSTEM

MDR report key: 1771049 · Received July 27, 2010

Report

Report Number
6000034-2010-00482
Event Type
Injury
Date Received
July 27, 2010
Date of Event
June 29, 2010
Report Date
March 8, 2011
Manufacturer
COCHLEAR LTD.
Product Code
MCM
PMA / PMN Number
840024
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
VA, US
Reporter Occupation
AUDIOLOGIST

Narratives

Additional Manufacturer Narrative · 1

(B) (4)

Additional Manufacturer Narrative · 1

THIS REPORT IS FILED (B)(6), 2011.

Description of Event or Problem · 1

PER THE CLINIC, ON (B) (4) 2007, THE PATIENT EXPERIENCED FACIAL NERVE STIMULATION AND FACIAL NERVE PARALYSIS. A VISIT TO THE EMERGENCY ROOM ON (B) (4) 2008 RESULTED IN THE DIAGNOSIS OF AN UNIDENTIFIED VIRUS. REPROGRAMMING THE DEVICE AFTER THE VIRUS RESOLVED ITSELF RESULTED IN SOME PERFORMANCE IMPROVEMENT. SUBSEQUENTLY, THE PATIENT DESIRED EXPLANTATION AND THE MANUFACTURER BECAME AWARE UPON RECEIPT OF THE EXPLANTED DEVICE ON (B) (4) 2010.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 NUCLEUS 22 CHANNEL COCHLEAR IMPLANT SYSTEM MCM, PRODUCT CODE: MCM MCM COCHLEAR LTD. CI22M N/A

Patients

Seq Age Sex Outcome Treatment
1 50 YR Required Intervention