FDA Adverse Event Injury Summary report: N

NUCLEUS HYBRID L24

MDR report key: 6172773 · Received December 13, 2016

Report

Report Number
6000034-2016-02524
Event Type
Injury
Date Received
December 13, 2016
Date of Event
December 7, 2016
Report Date
February 21, 2017
Manufacturer
COCHLEAR LTD
Product Code
PGQ
UDI-DI
09321502012089
PMA / PMN Number
P130016
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
CT, US
Reporter Occupation
AUDIOLOGIST

Narratives

Additional Manufacturer Narrative · 0

THIS REPORT IS SUBMITTED ON DECEMBER 14, 2016, BY COCHLEAR LIMITED ON BEHALF OF (B)(4). EXEMPTION NUMBER E2016011.

Description of Event or Problem · 0

PER THE CLINIC, THE PATIENT EXPERIENCED POOR PERFORMANCE WITH DEVICE USE AND A SUBSEQUENT REDUCTION IN CLINICAL BENEFIT, RESULTING IN THE DECISION TO EXPLANT. THE DEVICE WAS EXPLANTED ON (B)(6) 2016, AND THE PATIENT WAS RE-IMPLANTED WITH A NEW DEVICE DURING THE SAME SURGERY.

Additional Manufacturer Narrative · 1

THIS REPORT IS FILED ON MARCH 03, 2017.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
820591 NUCLEUS HYBRID L24 NUCLEUS HYBRID COCHLEAR IMPLANT SYSTEM PGQ COCHLEAR LTD CI24RE (L24) N/A 09321502012089

Patients

Seq Age Sex Outcome Treatment
1 62 YR Required Intervention