FDA Adverse Event Injury Summary report: N

NUCLEUS CI512 COCHLEAR IMPLANT WITH CONTOUR ADVANCE ELECTRODE

MDR report key: 8329992 · Received February 11, 2019

Report

Report Number
6000034-2019-00181
Event Type
Injury
Date Received
February 11, 2019
Date of Event
October 29, 2018
Report Date
March 12, 2019
Manufacturer
COCHLEAR LTD
Product Code
MCM
UDI-DI
09321502014564
PMA / PMN Number
P970051
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
CA
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 0

THIS REPORT IS FILED ON APRIL 05, 2019.

Additional Manufacturer Narrative · 0

THIS REPORT IS SUBMITTED ON FEBRUARY 12, 2019, BY COCHLEAR LIMITED ON BEHALF OF (B)(4). EXEMPTION NUMBER E2016011.

Description of Event or Problem · 0

PER THE CLINIC, THE PATIENT EXPERIENCED NO AUDITORY STIMULATION WITH DEVICE USE AS A RESULT OF UNSUCCESSFUL INSERTION; SUBSEQUENTLY THE DEVICE WAS EXPLANTED ON (B)(6) 2018 AND THE PATIENT WAS RE-IMPLANTED WITH A NEW DEVICE DURING THE SAME SURGERY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
118036 NUCLEUS CI512 COCHLEAR IMPLANT WITH CONTOUR ADVANCE ELECTRODE NUCLEUS 24 COCHLEAR IMPLANT SYSTEM MCM COCHLEAR LTD CI512 N/A 09321502014564

Patients

Seq Age Sex Outcome Treatment
1 48 YR Required Intervention