FDA Adverse Event Malfunction Summary report: N

NUCLEUS 24 CHANNEL COCHLEAR IMPLANT SYSTEM

MDR report key: 500878 · Received December 4, 2003

Report

Report Number
6000034-2003-00246
Event Type
Malfunction
Date Received
December 4, 2003
Date of Event
November 12, 2003
Report Date
December 4, 2003
Manufacturer
COCHLEAR LTD.
Product Code
MCM
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
SZ
Reporter Occupation
OTHER

Narratives

Description of Event or Problem · 1

THE PATIENT EXPERIENCED A BLOW TO THE HEAD WITH SUBSEQUENT LOSS OF IMPLANT FUNCTION. USING THE APPROPRIATE DIAGNOSTIC EQUIPMENT, IT WAS DETERMINED THAT THE DEVICE IS NOT FUNCTIONING ACCORDING TO MANUFACTURER'S SPECIFICATIONS. EXPLANTATION/REIMPLANTATION SURGERY WAS PERFORMED IN 2003. THE HEALTHCARE PROFESSIONAL HAS BEEN INFORMED THAT THE EXPLANTED DEVICE SHOULD BE RETURNED TO COCHLEAR LTD.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 NUCLEUS 24 CHANNEL COCHLEAR IMPLANT SYSTEM 24 CHANNEL COCHLEAR IMPLANT MCM COCHLEAR LTD. CI24M NA

Patients

Seq Age Sex Outcome Treatment
1 9 YR