FDA Adverse Event Injury Summary report: N

NUCLEUS 24 CHANNEL COCHLEAR IMPLANT SYSTEM

MDR report key: 2001613 · Received February 25, 2011

Report

Report Number
6000034-2011-00117
Event Type
Injury
Date Received
February 25, 2011
Date of Event
September 23, 2010
Report Date
August 8, 2011
Manufacturer
COCHLEAR LTD.
Product Code
MCM
PMA / PMN Number
970051
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
CO
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 SURGEON, THE DEVICE WAS EXPLANTED DUE TO INFECTION AND PARTIAL EXTRUSION OF THE DEVICE. THE DEVICE WAS EXPLANTED ON (B)(4), 2010. THERE ARE NO PLANS TO REIMPLANT THE PATIENT WITH ANOTHER DEVICE AS OF THE DATE OF THIS REPORT, (B)(4), 2011.

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. CI24RE (CA) N/A

Patients

Seq Age Sex Outcome Treatment
1 78 YR Required Intervention