FDA Adverse Event Injury Summary report: N

NUCLEUS FREEDOM IMPLANT WITH STRAIGHT ELECTRODE

MDR report key: 9121584 · Received September 26, 2019

Report

Report Number
6000034-2019-01918
Event Type
Injury
Date Received
September 26, 2019
Report Date
October 4, 2019
Manufacturer
COCHLEAR LTD
Product Code
MCM
UDI-DI
09321502025683
PMA / PMN Number
P970051
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
NL
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 0

THIS REPORT IS SUBMITTED OCTOBER 30, 2019. - ATTACHMENT: [153401 DEVICE ANALYSIS REPORT REG.PDF].

Additional Manufacturer Narrative · 1

THIS REPORT IS SUBMITTED ON SEPTEMBER 26, 2019.

Description of Event or Problem · 1

PER THE PATIENT'S SURGEON, THE PATIENT'S DEVICE WAS EXPLANTED ON JULY 17, 2019 DUE TO INFECTION AT IMPLANT SITE. THERE ARE NO PLANS TO RE-IMPLANT THE PATIENT WITH A NEW DEVICE AS OF THE DATE OF THIS REPORT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
917819 NUCLEUS FREEDOM IMPLANT WITH STRAIGHT ELECTRODE NUCLEUS 24 COCHLEAR IMPLANT SYSTEM MCM COCHLEAR LTD CI24RE (ST) N/A 09321502025683

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention