FDA Adverse Event Injury Summary report: N

NUCLEUS CI522 COCHLEAR IMPLANT WITH SLIM STRAIGHT ELECTRODE

MDR report key: 8924032 · Received August 22, 2019

Report

Report Number
6000034-2019-01538
Event Type
Injury
Date Received
August 22, 2019
Report Date
December 3, 2019
Manufacturer
COCHLEAR LTD
Product Code
MCM
UDI-DI
09321502032599
PMA / PMN Number
P970051
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
TN, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 0

THIS REPORT IS SUBMITTED DECEMBER 30, 2019. - ATTACHMENT: [151107 DEVICE ANALYSIS REPORT REG.PDF].

Additional Manufacturer Narrative · 1

THIS REPORT IS SUBMITTED ON AUGUST 23, 2019.

Description of Event or Problem · 1

PER THE CLINIC, THE PATIENT EXPERIENCED POOR PERFORMANCE WITH DEVICE USE; SUBSEQUENTLY THE DEVICE WAS EXPLANTED ON (B)(6) 2019 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
713239 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