FDA Adverse Event Injury Summary report: N

NUCLEUS CI522 COCHLEAR IMPLANT WITH SLIM STRAIGHT ELECTRODE

MDR report key: 6371052 · Received March 1, 2017

Report

Report Number
6000034-2017-00451
Event Type
Injury
Date Received
March 1, 2017
Report Date
March 20, 2017
Manufacturer
COCHLEAR LTD
Product Code
MCM
UDI-DI
09321502032599
PMA / PMN Number
P970051
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Occupation
PATIENT

Narratives

Additional Manufacturer Narrative · 0

THIS REPORT IS SUBMITTED ON MARCH 02, 2017, BY COCHLEAR LIMITED ON BEHALF OF (B)(4) EXEMPTION NUMBER E2016011.

Description of Event or Problem · 0

PER THE CLINIC, THE PATIENT EXPERIENCED PAIN AND MAGNET DISLODGEMENT DURING AN MRI (TESLA UNKNOWN). REVISION SURGERY TO REPOSITION THE MAGNET IS SCHEDULED; HOWEVER, IT IS UNKNOWN IF THIS HAS OCCURRED AS OF THE DATE OF THIS REPORT, MARCH 02, 2017.

Additional Manufacturer Narrative · 1

PER THE CLINIC, THE PATIENT WAS PLACED UNDER GENERAL ANAESTHESIA AND UNDERWENT REVISION SURGERY ON (B)(6) 2017, TO REPLACE MAGNET. THIS REPORT IS FILED ON APRIL 04, 2017.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
150489 NUCLEUS CI522 COCHLEAR IMPLANT WITH SLIM STRAIGHT ELECTRODE NUCLEUS 24 COCHLEAR IMPLANT SYSTEM MCM COCHLEAR LTD CI522 N/A 09321502032599

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention