FDA Adverse Event Malfunction Summary report: N

NUCLEUS 24 CHANNEL COCHLEAR IMPLANT SYSTEM

MDR report key: 1971958 · Received January 27, 2011

Report

Report Number
6000034-2011-00058
Event Type
Malfunction
Date Received
January 27, 2011
Date of Event
January 20, 2011
Report Date
June 22, 2011
Manufacturer
COCHLEAR LTD.
Product Code
MCM
PMA / PMN Number
970051
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
AUDIOLOGIST

Narratives

Additional Manufacturer Narrative · 1

(B)(4): IMPLANTED DEVICE REMAINS.

Additional Manufacturer Narrative · 1

PER PATIENT'S SURGEON, THE DEVICE WAS EXPLANTED ON (B)(6), 2011; DURING THE SAME SURGERY THE PATIENT WAS REIMPLANTED WITH ANOTHER DEVICE. THIS REPORT IS FILED (B)(4), 2011.

Additional Manufacturer Narrative · 1

(B)(4).

Description of Event or Problem · 1

PER THE CLINIC, THE PATIENT REPORTED INTERMITTENT CONTACT WITH THE INTERNAL DEVICE. IT IS UNKNOWN WHETHER THERE ARE PLANS TO EXPLANT AND REIMPLANT THE PATIENT AS OF THE DATE OF THIS REPORT, (B)(6), 2011. THE IMPLANTED DEVICE REMAINS.

Devices

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

Patients

Seq Age Sex Outcome Treatment
1 4 YR Required Intervention