FDA Adverse Event Malfunction Summary report: N

NUCLEUS 22 CHANNEL COCHLEAR IMPLANT SYSTEM.

MDR report key: 3965156 · Received July 29, 2014

Report

Report Number
6000034-2014-01040
Event Type
Malfunction
Date Received
July 29, 2014
Date of Event
September 3, 2014
Report Date
December 5, 2014
Manufacturer
COCHLEAR LTD.
Product Code
MCM
PMA / PMN Number
890027
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA
Reporter Occupation
AUDIOLOGIST

Narratives

Additional Manufacturer Narrative · 1

THIS REPORT IS FILED JANUARY 19TH, 2015.

Additional Manufacturer Narrative · 1

(B)(4): THE IMPLANTED DEVICE REMAINS.

Additional Manufacturer Narrative · 1

PER THE CLINIC, THE DEVICE WAS EXPLANTED ON (B)(6) 2014; DURING THE SAME SURGERY, THE PATIENT WAS RE IMPLANTED WITH A NEW DEVICE. THE DEVICE HAS NOT BEEN MADE AVAILABLE AS OF THE DATE OF THIS REPORT, SEPTEMBER 14, 2014.

Description of Event or Problem · 1

PER THE CLINIC, THE PATIENT LOST CONNECTION WITH THE INTERNAL DEVICE AND THE ISSUE COULD NOT BE RESOLVED. THE IMPLANTED DEVICE REMAINS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
440959 NUCLEUS 22 CHANNEL COCHLEAR IMPLANT SYSTEM. MCM MCM COCHLEAR LTD. CI22M N/A

Patients

Seq Age Sex Outcome Treatment
1 38 YR Required Intervention