FDA Adverse Event Malfunction Summary report: N

NUCLEUS 24 CHANNEL COCHLEAR IMPLANT SYSTEM

MDR report key: 3020272 · Received March 25, 2013

Report

Report Number
6000034-2013-00551
Event Type
Malfunction
Date Received
March 25, 2013
Date of Event
March 18, 2013
Report Date
August 21, 2013
Manufacturer
COCLEAR LTD
Product Code
MCM
PMA / PMN Number
970051
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
TX, US
Reporter Occupation
AUDIOLOGIST

Narratives

Additional Manufacturer Narrative · 1

THIS REPORT IS FILED (B)(4) 2013.

Additional Manufacturer Narrative · 1

PER PATIENT'S SURGEON, THE DEVICE WAS EXPLANTED ON (B)(6) 2013; DURING THE SAME SURGERY THE PATIENT WAS REIMPLANTED WITH A NEW DEVICE. THIS REPORT IS FILED (B)(4) 2013.

Additional Manufacturer Narrative · 1

IMPLANTED DEVICE REMAINS.

Description of Event or Problem · 1

PER THE CLINIC, THE PATIENT EXPERIENCED A LOSS OF CONNECTION TO THE INTERNAL DEVICE, AND 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 ANOTHER DEVICE AS OF THE DATE OF THIS REPORT, (B)(4) 2013.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
121450 NUCLEUS 24 CHANNEL COCHLEAR IMPLANT SYSTEM MCM, PRODUCT CODE: MCM MCM COCLEAR LTD CI512

Patients

Seq Age Sex Outcome Treatment
1 7 YR Required Intervention