FDA Adverse Event Malfunction Summary report: N

NUCLEUS 24 CHANNEL COCHLEAR IMPLANT SYSTEM

MDR report key: 3171039 · Received June 14, 2013

Report

Report Number
6000034-2013-01050
Event Type
Malfunction
Date Received
June 14, 2013
Date of Event
May 30, 2013
Report Date
November 6, 2013
Manufacturer
COCHLEAR LTD
Product Code
MCM
PMA / PMN Number
970051
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
IA, US
Reporter Occupation
AUDIOLOGIST

Narratives

Additional Manufacturer Narrative · 1

(B)(4).

Additional Manufacturer Narrative · 1

THIS REPORT IS FILED DECEMBER 16, 2013.

Additional Manufacturer Narrative · 1

PER THE CLINIC, THE DEVICE WAS EXPLANTED ON (B)(6) 2013; THE PATIENT WAS REIMPLANTED WITH A NEW DEVICE DURING THE SAME SURGERY. THIS REPORT IS FILED OCTOBER 16, 2013.

Description of Event or Problem · 1

PER THE CLINIC, THE PATIENT REPORTED OVERLY LOUD SOUNDS AND "SHOCKING SENSATION" WITH DEVICE USE. THE ISSUE COULD NOT BE RESOLVED. THE DEVICE WAS EXPLANTED (B)(6) 2013, AND THE PATIENT WAS REIMPLANTED WITH A NEW DEVICE DURING THE SAME SURGERY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
271470 NUCLEUS 24 CHANNEL COCHLEAR IMPLANT SYSTEM MCM MCM COCHLEAR LTD CI512

Patients

Seq Age Sex Outcome Treatment
1 54 YR Required Intervention