FDA Adverse Event Injury Summary report: N

HIRES 90K

MDR report key: 2130682 · Received June 10, 2011

Report

Report Number
3006556115-2011-00319
Event Type
Injury
Date Received
June 10, 2011
Date of Event
March 1, 2011
Report Date
May 20, 2011
Manufacturer
ADVANCED BIONICS, LLC
Product Code
MCM
PMA / PMN Number
P960058
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
UT, US
Reporter Occupation
AUDIOLOGIST

Narratives

Description of Event or Problem · 1

THE PT REPORTEDLY REC'D PE TUBES IN (B)(6) 2011. ADVANCED BIONICS IS IN THE PROCESS OF GATHERING MORE INFORMATION; ONCE MORE INFORMATION IS AVAILABLE, A SUPPLEMENTAL REPORT WILL BE SUBMITTED.

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 24 MO Required Intervention