FDA Adverse Event Malfunction Summary report: N

NUCLEUS 24 CHANNEL COCHLEAR IMPLANT SYSTEM

MDR report key: 2062711 · Received April 19, 2011

Report

Report Number
6000034-2011-00268
Event Type
Malfunction
Date Received
April 19, 2011
Date of Event
October 28, 2010
Report Date
March 28, 2012
Manufacturer
COCHLEAR LTD.
Product Code
MCM
PMA / PMN Number
970051
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
AR
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

Narratives

Additional Manufacturer Narrative · 1

(B)(4): THE IMPLANTED DEVICE REMAINS.

Additional Manufacturer Narrative · 1

PER PATIENT'S SURGEON, THE DEVICE WAS EXPLANTED (DATE UNKNOWN). IT IS UNKNOWN IF THE PATIENT WAS REIMPLANTED WITH A NEW DEVICE. ADDITIONAL INFORMATION HAS BEEN REQUEST BUT NOT YET RECEIVED AS OF THE DATE OF THIS REPORT. (B)(4).

Additional Manufacturer Narrative · 1

PER THE PATIENT'S SURGEON, THE PATIENT WAS REIMPLANTED WITH A NEW DEVICE (B)(6) 2011. DEVICE NOT AVAILABLE FOR ANALYSIS. THIS REPORT IS FILED (B)(4) 2012.

Description of Event or Problem · 1

PER THE CLINIC, THE PATIENT EXPERIENCED A PERFORMANCE DECREMENT. REPROGRAMMING ATTEMPTS WERE MADE; HOWEVER, THE ISSUE COULD NOT BE RESOLVED. EXPLANT AND REIMPLANTATION IS PLANNED BUT HAD NOT TAKEN PLACE AT THE TIME 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. CI24R (ST) N/A

Patients

Seq Age Sex Outcome Treatment
1 12 YR Required Intervention