FDA Adverse Event Malfunction Summary report: N

PROVOX2 VOICE PROSTHESIS

MDR report key: 889048 · Received July 23, 2007

Report

Report Number
8032044-2007-00010
Event Type
Malfunction
Date Received
July 23, 2007
Date of Event
April 12, 2007
Report Date
July 23, 2007
Manufacturer
ATOS MEDICAL AB
Product Code
EWL
PMA / PMN Number
K971244
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA

Narratives

Additional Manufacturer Narrative · 1

CORRECTIVE ACTIONS HAVE BEEN IMPLEMENTED AND REPORTED IN CONNECTION WITH FOLLOW-UP REPORT REGARDING MFR REPORT #8032044-2007-00004.

Description of Event or Problem · 1

VALVE OF PROVOX 2 WAS "DISLODGED" DURING INSERTION WHICH MADE VALVE NON-FUNCTIONAL.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 PROVOX2 VOICE PROSTHESIS VOICE PROSTHESIS EWL ATOS MEDICAL AB PROVOX2 8MM 0701003

Patients

Seq Age Sex Outcome Treatment
1 YR