FDA Adverse Event Injury Summary report: N

NUCLEUS 24 CHANNEL COCHLEAR IMPLANT SYSTEM.

MDR report key: 2113648 · Received June 3, 2011

Report

Report Number
6000034-2011-00392
Event Type
Injury
Date Received
June 3, 2011
Date of Event
April 18, 2011
Report Date
May 27, 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).

Description of Event or Problem · 1

PER THE CLINIC, THE DEVICE WAS EXPLANTED DUE TO INFECTION AND SUBSEQUENT DEVICE EXTRUSION. THE DEVICE WAS EXPLANTED (B)(6), 2011. IT IS UNKNOWN WHETHER THERE ARE PLANS TO REIMPLANT THE PATIENT WITH ANOTHER DEVICE 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 MCM COCHLEAR LTD CI24R (CS) N/A

Patients

Seq Age Sex Outcome Treatment
1 13 YR Required Intervention