FDA Adverse Event Injury Summary report: N

NUCLEUS 24 CHANNEL COCHLEAR IMPLANT SYSTEM

MDR report key: 2162490 · Received July 14, 2011

Report

Report Number
6000034-2011-00486
Event Type
Injury
Date Received
July 14, 2011
Date of Event
June 9, 2011
Report Date
August 9, 2011
Manufacturer
COCHLEAR LTD.
Product Code
MCM
PMA / PMN Number
970051
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
AS
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

Narratives

Additional Manufacturer Narrative · 1

(B)(4).

Additional Manufacturer Narrative · 1

THIS REPORT IS FILED (B)(4), 2011.

Description of Event or Problem · 1

PER THE CLINIC, THE PATIENT SUSTAINED A TRAUMA OVER THE IMPLANT SITE RESULTING IN A SUBSEQUENT INFECTION AND SKIN FLAP NECROSIS. THE DEVICE WAS EXPLANTED ON (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, PRODUCT CODE: MCM MCM COCHLEAR LTD. CI24RE (CA) N/A

Patients

Seq Age Sex Outcome Treatment
1 9 YR Required Intervention