MAUDE Adverse Event Report: COCHLEAR LIMITED NUCLEUS CI622 COCHLEAR IMPLANT WITH SLIM STRAIGHT ELECTRODE; NUCLEUS 24 COCHLEAR IMPLANT SYSTEM

Model Number CI622

Device Problem Expulsion (2933)

Patient Problems Drug Resistant Bacterial Infection (4553); Appropriate Clinical Signs, Symptoms, Conditions Term / Code Not Available (4581)

Event Type  Injury  

Manufacturer Narrative

This report is submitted on march 1, 2021.

Event Description

Per the clinic, the patient experienced an extrusion of the electrode lead and was treated with oral antibiotics (duration and date not reported).The implanted device remains.

Manufacturer Narrative

Per the clinic, it was reported that the patient experienced mrsa infection and underwent a skin flap revision (specific date not reported).This report is submitted on 31 mar 2021.

Manufacturer Narrative

Per the clinic, the device was explanted on (b)(6) 2021.There are no plans to reimplant the patient with a new device as of the date of this report.This report is submitted on october 28, 2021.

• Brand Name: NUCLEUS CI622 COCHLEAR IMPLANT WITH SLIM STRAIGHT ELECTRODE
• Type of Device: NUCLEUS 24 COCHLEAR IMPLANT SYSTEM
• Manufacturer (Section D): COCHLEAR LIMITED; 1 university avenue; macquarie university; nsw 2109 ; AS 2109
• MDR Report Key: 11391061
• MDR Text Key: 233952303
• Report Number: 6000034-2021-00566
• Device Sequence Number: 1
• Product Code: MCM
• UDI-Device Identifier: 09321502036573
• UDI-Public: (01)09321502036573(11)200625(17)220624
• Combination Product (y/n): N
• PMA/PMN Number: P970051
• Number of Events Reported: 1
• Summary Report (Y/N): N
• Report Source: Manufacturer
• Source Type: health professional
• Type of Report: Initial,Followup,Followup
• Report Date: 10/06/2021

1 Device was Involved in the Event

1 Patient was Involved in the Event

• Is this an Adverse Event Report?: Yes
• Is this a Product Problem Report?: No
• Device Operator: Lay User/Patient
• Device Expiration Date: 06/24/2022
• Device Model Number: CI622
• Was Device Available for Evaluation?: Device Returned to Manufacturer
• Date Returned to Manufacturer: 10/06/2021
• Initial Date Manufacturer Received: 02/03/2021
• Initial Date FDA Received: 02/28/2021
• Supplement Dates Manufacturer Received: 03/03/2021; 10/06/2021
• Supplement Dates FDA Received: 03/31/2021; 10/28/2021
• Is This a Reprocessed and Reused Single-Use Device?: No
• Patient Sequence Number: 1
• Patient Outcome(s): Required Intervention