FDA Adverse Event Malfunction Summary report: N

HIRES¿ ULTRA IMPLANT

MDR report key: 18022644 · Received October 27, 2023

Report

Report Number
3006556115-2023-01923
Event Type
Malfunction
Date Received
October 27, 2023
Date of Event
October 7, 2025
Report Date
October 24, 2023
Manufacturer
ADVANCED BIONICS, LLC
Product Code
MCM
UDI-DI
07630016841002
PMA / PMN Number
P960058
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
GM
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

DISCLAIMER: ADVANCED BIONICS DOES NOT INTEND THAT THIS REPORT BE ANY ADMISSION OF LIABILITY, FAULT OR PRODUCT DEFECT.

Additional Manufacturer Narrative · 0

ADVANCED BIONICS CONSIDERS THE INVESTIGATION INTO THIS REPORTABLE EVENT AS CLOSED. THE RECIPIENT WILL REPORTEDLY NOT PURSUE REVISION SURGERY AT THIS TIME. THE RECIPIENT CONTINUES TO USE THE DEVICE AND WILL BE MANAGED BY THE FACILITY. NO FURTHER DETAILS WILL BE PROVIDED. THIS IS THE FINAL REPORT. DISCLAIMER: ADVANCED BIONICS DOES NOT INTEND THAT THIS REPORT BE ANY ADMISSION OF LIABILITY, FAULT OR PRODUCT DEFECT.

Additional Manufacturer Narrative · 0

ADDITIONAL INFORMATION: SECTIONS B.3, D.6B, D.9 & H.6. THE RECIPIENT'S DEVICE WAS EXPLANTED. THE RECIPIENT WAS RE-IMPLANTED WITH ANOTHER ADVANCED BIONICS COCHLEAR DEVICE. THE EXPLANTED DEVICE WAS RECEIVED BY ADVANCED BIONICS OCTOBER 28, 2025. ADVANCED BIONICS IS CURRENTLY ATTEMPTING TO OBTAIN CONSENT FROM THE RECIPIENT. THE DEVICE REMAINS INTACT IN A LOCKED VAULT AT AB, LLC UNTIL CONSENT IS OBTAINED. DISCLAIMER: ADVANCED BIONICS DOES NOT INTEND THAT THIS REPORT BE ANY ADMISSION OF LIABILITY, FAULT OR PRODUCT DEFECT.

Description of Event or Problem · 0

A REVIEW OF THE RECIPIENT'S TEST DATA INDICATES IMPEDANCE ISSUES. REVISION SURGERY IS UNDER CONSIDERATION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1434253 HIRES¿ ULTRA IMPLANT COCHLEAR IMPLANT MCM ADVANCED BIONICS, LLC CI-1600-04 NA 07630016841002

Patients

Seq Age Sex Outcome Treatment
1 NA Male