FDA Adverse Event Injury Summary report: N

NUCLEUS 24 CHANNEL COCHLEAR IMPLANT SYSTEM

MDR report key: 1912082 · Received December 1, 2010

Report

Report Number
6000034-2010-00752
Event Type
Injury
Date Received
December 1, 2010
Date of Event
November 16, 2010
Report Date
February 23, 2011
Manufacturer
COCHLEAR LTD.
Product Code
MCM
PMA / PMN Number
970051
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
CA
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

(B)(4).

Additional Manufacturer Narrative · 1

(B)(4)

Description of Event or Problem · 1

PER THE CLINIC, THE DEVICE WAS EXPLANTED DUE TO A SKIN FLAP BREAKDOWN AND SUBSEQUENT INFECTION. THE DEVICE WAS EXPLANTED ON (B)(6), 2010. THERE ARE CURRENTLY NO PLANS TO REIMPLANT THE PATIENT WITH ANOTHER DEVICE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 NUCLEUS 24 CHANNEL COCHLEAR IMPLANT SYSTEM MCM MCM COCHLEAR LTD. CI512 N/A

Patients

Seq Age Sex Outcome Treatment
1 37 YR Required Intervention