FDA Adverse Event Injury Summary report: N

NUCLEUS 24 CHANNEL COCHLEAR IMPLANT SYSTEM

MDR report key: 2242051 · Received September 9, 2011

Report

Report Number
6000034-2011-00681
Event Type
Injury
Date Received
September 9, 2011
Date of Event
August 18, 2011
Report Date
August 24, 2012
Manufacturer
COCHLEAR LTD.
Product Code
MCM
PMA / PMN Number
970051
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
SZ
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

Narratives

Additional Manufacturer Narrative · 1

(B)(4). THIS REPORT IS FILED (B)(4) 2012.

Additional Manufacturer Narrative · 1

(B)(4).

Description of Event or Problem · 1

PER THE CLINIC, THE DEVICE WAS EXPLANTED DUE TO TELEMETRY PROBLEMS. REPROGRAMMING ATTEMPTS WERE MADE; HOWEVER, THE ISSUE COULD NOT BE RESOLVED. THE DEVICE WAS EXPLANTED (B)(6) 2011, AND THE PATIENT WAS REIMPLANTED WITH A NEW DEVICE DURING THE SAME SURGERY.

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 13 YR Required Intervention