FDA Adverse Event Injury Summary report: N

HIRES 90K

MDR report key: 2062720 · Received April 13, 2011

Report

Report Number
3006556115-2011-00159
Event Type
Injury
Date Received
April 13, 2011
Date of Event
April 1, 2011
Report Date
March 23, 2011
Manufacturer
ADVANCED BIONICS LLC
Product Code
MCM
PMA / PMN Number
P960058
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
WA, US
Reporter Occupation
AUDIOLOGIST

Narratives

Description of Event or Problem · 1

THE COMPANY WAS INFORMED THAT THE PT'S DEVICE WAS EXPLANTED FOR MEDICAL REASONS. IT WAS REPORTED THAT THE PT HAD AN EXPOSED ELECTRODE ARRAY AND INFECTION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 HIRES 90K COCHLEAR IMPLANT MCM ADVANCED BIONICS LLC CI-1400-01 NA

Patients

Seq Age Sex Outcome Treatment
1 67 YR Required Intervention