FDA Adverse Event Injury Summary report: N

NUCLEUS 24 CHANNEL COCHLEAR IMPLANT SYSTEM

MDR report key: 2063491 · Received April 19, 2011

Report

Report Number
6000034-2011-00275
Event Type
Injury
Date Received
April 19, 2011
Date of Event
March 8, 2011
Report Date
July 26, 2011
Manufacturer
COCHLEAR LTD.
Product Code
MCM
PMA / PMN Number
970051
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
SZ
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 CLINIC, THE DEVICE WAS EXPLANTED DUE TO PATIENT REPORTS OF HEADACHES. THE DEVICE WAS EXPLANTED ON (B)(6), 2011. IT IS UNKNOWN IF REIMPLANTATION IS PLANNED BUT HAS NOT TAKEN PLACE AS OF THE DATE OF THIS REPORT (B)(6), 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 21 YR Required Intervention