FDA Adverse Event Malfunction Summary report: N

NUCLEUS 24 CHANNEL COCHLEAR IMPLANT SYSTEM

MDR report key: 2231896 · Received September 1, 2011

Report

Report Number
6000034-2011-00648
Event Type
Malfunction
Date Received
September 1, 2011
Date of Event
August 12, 2011
Report Date
August 21, 2012
Manufacturer
COCHLEAR LTD.
Product Code
MCM
PMA / PMN Number
970051
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
FL, US
Reporter Occupation
AUDIOLOGIST

Narratives

Additional Manufacturer Narrative · 1

(B)(4). IMPLANTED DEVICE REMAINS.

Additional Manufacturer Narrative · 1

PER PATIENT'S SURGEON, THE DEVICE WAS EXPLANTED ON (B)(6), 2011; DURING THE SAME SURGERY THE PATIENT WAS REIMPLANTED WITH A NEW DEVICE.THIS REPORT IS FILED (B)(6), 2011.

Additional Manufacturer Narrative · 1

THE DEVICE IS NOT AVAILABLE FOR ANALYSIS. THIS REPORT IS FILED (B)(4) 2012.

Description of Event or Problem · 1

PER THE CLINIC, THE PATIENT EXPERIENCED A LOSS OF CONNECTION TO THE INTERNAL DEVICE AFTER REPORTEDLY DRIVING UNDER A STREET LIGHT. THE IMPLANTED DEVICE REMAINS. THERE ARE PLANS TO EXPLANT THE DEVICE AND TO REIMPLANT THE PATIENT WITH ANOTHER DEVICE BUT THIS HAS NOT OCCURRED 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. CI512 N/A

Patients

Seq Age Sex Outcome Treatment
1 44 YR Required Intervention