FDA Adverse Event Injury Summary report: N

NUCLEUS 22 CHANNEL COCHLEAR IMPLANT SYSTEM

MDR report key: 1890214 · Received November 3, 2010

Report

Report Number
6000034-2010-00686
Event Type
Injury
Date Received
November 3, 2010
Date of Event
July 22, 2010
Report Date
February 16, 2011
Manufacturer
COCHLEAR LTD.
Product Code
MCM
PMA / PMN Number
890027
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
SZ
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

Narratives

Additional Manufacturer Narrative · 1

(B)(4).

Additional Manufacturer Narrative · 1

(B)(4).

Description of Event or Problem · 1

PER THE CLINIC, THE PATIENT EXPERIENCED A PERFORMANCE DECREMENT. IT WAS REPORTED THAT THE SEVERAL ELECTRODES WERE EXTRACOCHLEAR, RESULTING IN THE DECISION TO EXPLANT THE DEVICE. THE DEVICE WAS EXPLANTED (B)(6), 2010, AND THE PATIENT WAS REIMPLANTED WITH A NEW DEVICE DURING THE SAME SURGERY.

Devices

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

Patients

Seq Age Sex Outcome Treatment
1 39 YR Required Intervention