FDA Adverse Event
Malfunction
Summary report: N
HIRES 90K
MDR report key: 2231622
·
Received August 22, 2011
Report
- Report Number
- 3006556115-2011-00400
- Event Type
- Malfunction
- Date Received
- August 22, 2011
- Date of Event
- August 1, 2011
- Report Date
- August 1, 2011
- Manufacturer
- ADVANCED BIONICS, LLC
- Product Code
- MCM
- PMA / PMN Number
- P960058
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- CO
- Reporter Occupation
- OTHER
Narratives
Description of Event or Problem · 1
THE PATIENT REPORTEDLY EXPERIENCED LOSS OF SOUND. EXTERNAL EQUIPMENT WAS EXCHANGED; HOWEVER, THIS DID NOT RESOLVE THE ISSUE. SURGERY TO EXPLANT THE PATIENT'S DEVICE WILL BE SCHEDULED.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1 | HIRES 90K | COCHLEAR IMPLANT | MCM | ADVANCED BIONICS, LLC | CI-1400-02H | NA |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 13 YR |