FDA Adverse Event Malfunction Summary report: N

NUCLEUS 24 CHANNEL COCHLEAR IMPLANT SYSTEM

MDR report key: 2781694 · Received October 11, 2012

Report

Report Number
6000034-2012-01920
Event Type
Malfunction
Date Received
October 11, 2012
Date of Event
October 4, 2012
Report Date
May 1, 2013
Manufacturer
COCHLEAR LTD
Product Code
MCM
PMA / PMN Number
970051
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
TU
Reporter Occupation
AUDIOLOGIST

Narratives

Additional Manufacturer Narrative · 1

PER THE PATIENT'S SURGEON, THE DEVICE WAS EXPLANTED ON (B)(6) 2012 AND THE PATIENT WAS REIMPLANTED WITH ANOTHER DEVICE DURING THE SAME SURGERY. (B)(4).

Additional Manufacturer Narrative · 1

(B)(4). IMPLANTED DEVICE REMAINS.

Description of Event or Problem · 1

PER THE CLINIC, THE PATIENT EXPERIENCED A SUDDEN LOSS OF CONNECTION TO THE INTERNAL DEVICE. REPROGRAMMING ATTEMPTS WERE MADE; HOWEVER, THE ISSUE COULD NOT BE RESOLVED. THE IMPLANTED DEVICE REMAINS. IT IS UNKNOWN IF THERE ARE PLANS TO EXPLANT THE DEVICE AND TO REIMPLANT THE PATIENT WITH A NEW DEVICE AS OF THE DATE OF THIS REPORT, (B)(6) 2012.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 NUCLEUS 24 CHANNEL COCHLEAR IMPLANT SYSTEM MCM MCM COCHLEAR LTD CI512

Patients

Seq Age Sex Outcome Treatment
1 4 YR Required Intervention