FDA Adverse Event Other Summary report: N

CLARION

MDR report key: 211193 · Received February 19, 1999

Report

Report Number
2029203-1999-00003
Event Type
Other
Date Received
February 19, 1999
Date of Event
January 20, 1999
Report Date
January 21, 1999
Manufacturer
ADVANCED BIONICS CORPORATION
Product Code
MCM
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
FR
Reporter Occupation
OTHER

Narratives

Description of Event or Problem · 1

A 39 YEAR-OLD MALE, WAS ORIGINALLY IMPLANTED ON 2/8/1994. HIS SYSTEM FUNCTIONED NORMALLY AND THERE WERE NO REPORTS OF ANY PROBLEMS OVER THE NEXT FIVE YEARS. ACCORDING TO INFO RECEIVED FROM THE IMPLANT CENTER, THE PT HAD BEEN DRINKING WHEN HE FELL DOWN AND STRUCK HIS HEAD ON A CAR DOOR. THERE WAS AN IMMEDIATE CESSATION OF DEVICE FUNCTIONALITY. TESTING CONDUCTED AT THE CENTER ON 1/21/1999, CONFIRMED THAT DEVICE WAS NO LONGER FUNCTIONING. EXPLANTATION/REIMPLANTATION TOOK PLACE ON 1/25/1999. PT WAS REIMPLANTED WITH ANOTHER CLARION DEVICE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 CLARION Implant COCHLEAR IMPLANT MCM ADVANCED BIONICS CORPORATION MMT-5100L NA

Patients

Seq Age Sex Outcome Treatment
1 39 YR