BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    HIRES 90K IMPLANT

    MDR report key: 3113269 · Received May 8, 2013

    Report

    Report Number
    3006556115-2013-00184
    Event Type
    Malfunction
    Date Received
    May 8, 2013
    Date of Event
    April 18, 2013
    Report Date
    April 18, 2013
    Manufacturer
    ADVANCED BIONICS LLC
    Product Code
    MCM
    PMA / PMN Number
    P960058
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    MO
    Reporter Occupation
    NO INFORMATION

    Narratives

    Description of Event or Problem · 1

    THE PT REPORTEDLY EXPERIENCED INTERMITTENCIES, FOLLOWED BY NO LOCK BETWEEN THE INTERNAL DEVICE AND EXTERNAL EQUIPMENT. PROGRAMMING ADJUSTMENTS HAVE BEEN MADE AND EXTERNAL EQUIPMENT EXCHANGED, HOWEVER THIS DID NOT RESOLVE THE ISSUE. REVISION SURGERY HAS BEEN SCHEDULED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    202194 HIRES 90K IMPLANT COCHLEAR IMPLANT MCM ADVANCED BIONICS LLC CI-1400-01 NA

    Patients

    Seq Age Sex Outcome Treatment
    1 5 YR