FDA Adverse Event Injury Summary report: N

HIRES 90K

MDR report key: 2101481 · Received May 12, 2011

Report

Report Number
3006556115-2011-00224
Event Type
Injury
Date Received
May 12, 2011
Date of Event
April 19, 2011
Report Date
April 21, 2011
Manufacturer
ADVANCED BIONICS, LLC
Product Code
MCM
PMA / PMN Number
P960058
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
GM
Reporter Occupation
HEALTH PROFESSIONAL

Narratives

Description of Event or Problem · 1

THE COMPANY WAS INFORMED THAT THE PATIENT'S DEVICE WAS EXPLANTED DUE TO POOR PERFORMANCE.

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 47 YR Required Intervention