FDA Adverse Event Injury Summary report: N

NUCLEUS 22 CHANNEL COCHLEAR IMPLANT SYSTEM

MDR report key: 3831695 · Received May 27, 2014

Report

Report Number
6000034-2014-00751
Event Type
Injury
Date Received
May 27, 2014
Date of Event
March 28, 2014
Report Date
August 4, 2014
Manufacturer
COCHLEAR LTD.
Product Code
MCM
PMA / PMN Number
840024
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
GM
Reporter Occupation
HEALTH PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

IT WAS REPORTED THAT THE DEVICE WAS EXPLANTED DUE TO DISLOCATION. THIS REPORT IS FILED AUGUST 6, 2014.

Additional Manufacturer Narrative · 1

(B)(4).

Description of Event or Problem · 1

PER THE CLINIC, THE DEVICE WAS EXPLANTED ON (B)(6) 2014 DUE TO AN UNSPECIFIC DEVICE ISSUE. THE PATIENT WAS REIMPLANTED WITH A NEW DEVICE DURING THE SAME SURGERY. ADDITIONAL INFORMATION HAS BEEN REQUESTED BUT HAS NOT BEEN MADE AVAILABLE AS OF THE DATE OF THIS REPORT, (B)(6) 2014.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
311702 NUCLEUS 22 CHANNEL COCHLEAR IMPLANT SYSTEM MCM MCM COCHLEAR LTD. CI22M

Patients

Seq Age Sex Outcome Treatment
1 22 YR Required Intervention