FDA Adverse Event Malfunction Summary report: N

NUCLEUS 24 CHANNEL COCHLEAR IMPLANT SYSTEM

MDR report key: 2220997 · Received August 23, 2011

Report

Report Number
6000034-2011-00626
Event Type
Malfunction
Date Received
August 23, 2011
Date of Event
July 15, 2011
Report Date
November 22, 2011
Manufacturer
COCHLEAR LTD.
Product Code
MCM
PMA / PMN Number
970051
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
SZ
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

Narratives

Additional Manufacturer Narrative · 1

PER PATIENT'S SURGEON, THE DEVICE WAS EXPLANTED ON (B)(6) 2011; IT IS UNKNOWN IF THE PATIENT WAS REIMPLANTED WITH A NEW DEVICE. (B)(4). THIS REPORT IS FILED (B)(4) 2012.

Additional Manufacturer Narrative · 1

(B)(4): IMPLANTED DEVICE REMAINS.

Description of Event or Problem · 1

PER THE CLINIC, AFTER A YEAR OF SUCCESSFUL IMPLANT USE THE PATIENT EXPERIENCED INTERMITTENCIES AND SUBSEQUENT LOSS OF CONNECTION TO THE INTERNAL DEVICE. THE IMPLANTED DEVICE REMAINS.

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. CI512 N/A

Patients

Seq Age Sex Outcome Treatment
1 33 MO Required Intervention