FDA Adverse Event Injury Summary report: N

NUCLEUS 24 CHANNEL COCHLEAR IMPLANT SYSTEM

MDR report key: 3013635 · Received March 20, 2013

Report

Report Number
6000034-2013-00540
Event Type
Injury
Date Received
March 20, 2013
Report Date
October 3, 2013
Manufacturer
COCHLEAR LTD
Product Code
MCM
PMA / PMN Number
970051
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
TX, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

(B)(4).

Additional Manufacturer Narrative · 1

PER THE CLINIC, THE DEVICE IS NOT AVAILABLE FOR ANALYSIS. THIS REPORT IS FILED DECEMBER 11, 2013. DEVICE NOT RETURNED TO MANUFACTURER.

Description of Event or Problem · 1

PER THE CLINIC, THE PATIENT EXPERIENCED EXTRUSION OF THE ELECTRODE ARRAY FROM THE COCHLEAR AND AUDITORY CANAL (DATE NOT REPORTED). THE DEVICE WAS EXPLANTED ON (B)(6) 2013, AND THE PATIENT WAS REIMPLANTED WITH ANOTHER DEVICE DURING THE SAME SURGERY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
115525 NUCLEUS 24 CHANNEL COCHLEAR IMPLANT SYSTEM MCM MCM COCHLEAR LTD CI24RE (CA)

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention