FDA Adverse Event Injury Summary report: N

HIRES 90K IMPLANT

MDR report key: 2850556 · Received November 16, 2012

Report

Report Number
3006556115-2012-00528
Event Type
Injury
Date Received
November 16, 2012
Date of Event
November 6, 2012
Report Date
October 31, 2012
Manufacturer
ADVANCED BIONICS, LLC
Product Code
MCM
PMA / PMN Number
P960058
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
AUDIOLOGIST

Narratives

Description of Event or Problem · 1

THE COMPANY WAS INFORMED THAT THE PT'S DEVICE WAS EXPLANTED DUE TO A CHOLESTEATOMA. THE PT WAS REIMPLANTED WITH ANOTHER ADVANCED BIONICS COCHLEAR DEVICE. THE PT IS REPORTEDLY DOING WELL.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 HIRES 90K IMPLANT COCHLEAR IMPLANT MCM ADVANCED BIONICS, LLC CI-1400-01 NA

Patients

Seq Age Sex Outcome Treatment
1 56 YR Required Intervention