FDA Adverse Event
Injury
Summary report: N
HIRES 90K
MDR report key: 2112391
·
Received May 27, 2011
Report
- Report Number
- 3006556115-2011-00265
- Event Type
- Injury
- Date Received
- May 27, 2011
- Date of Event
- April 14, 2011
- Report Date
- May 9, 2011
- Manufacturer
- ADVANCED BIONICS, LLC
- Product Code
- MCM
- PMA / PMN Number
- P960058
- Adverse Event
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- CA, US
- Reporter Occupation
- AUDIOLOGIST
Narratives
Description of Event or Problem · 1
THE PT REPORTEDLY EXPERIENCED PERFORMANCE ISSUES AND FACIAL NERVE STIMULATION. PROGRAMMING ADJUSTMENTS WERE MADE; HOWEVER, THIS DID NOT RESOLVE THE ISSUE. THE PT'S DEVICE WAS EXPLANTED AND THE PT WAS REIMPLANTED WITH ANOTHER COCHLEAR DEVICE.
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 | 59 YR | Required Intervention |