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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ADVANCED BIONICS, LLC HIRES 90K¿ ADVANTAGE IMPLANT; COCHLEAR IMPLANT

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ADVANCED BIONICS, LLC HIRES 90K¿ ADVANTAGE IMPLANT; COCHLEAR IMPLANT Back to Search Results
Model Number CI-1500-04
Device Problems Loose or Intermittent Connection (1371); Therapeutic or Diagnostic Output Failure (3023)
Patient Problems Fall (1848); Appropriate Clinical Signs, Symptoms, Conditions Term / Code Not Available (4581)
Event Date 11/17/2021
Event Type  Injury  
Event Description
The recipient reportedly experienced loss of lock.External equipment was exchanged, however, the issue was not resolved.The recipient reportedly falls on the implant side frequently due to vestibular areflexia.Revision surgery is scheduled.
 
Manufacturer Narrative
Disclaimer: advanced bionics does not intend that this report be any admission of liability, fault or product defect.
 
Manufacturer Narrative
The recipient's device was explanted.The recipient was re-implanted with another advanced bionics cochlear device.Disclaimer: advanced bionics does not intend that this report be any admission of liability, fault or product defect.
 
Manufacturer Narrative
Disclaimer: advanced bionics does not intend that this report be any admission of liability, fault or product defect.
 
Manufacturer Narrative
Advanced bionics considers the investigation into this reportable event as closed.The external visual inspection revealed tool damage to the top cover.This is believed to have occurred during revision surgery.Photographic imaging inspection revealed broken antenna wires.System lock was lost while manipulating the antenna.The device passed the electrical tests performed.The device passed the mechanical test performed.This device had an open antenna.Advance bionics will continue to monitor failure modes of this type.This is the final report.Disclaimer: advanced bionics does not intend that this report be any admission of liability, fault or product defect.
 
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Brand Name
HIRES 90K¿ ADVANTAGE IMPLANT
Type of Device
COCHLEAR IMPLANT
Manufacturer (Section D)
ADVANCED BIONICS, LLC
28515 westinghouse place
valencia CA 91355
Manufacturer Contact
heidi white
28515 westinghouse place
valencia, CA 91355
MDR Report Key12540781
MDR Text Key273640499
Report Number3006556115-2021-01420
Device Sequence Number1
Product Code MCM
UDI-Device Identifier07630016832185
UDI-Public(01)07630016832185(11)160720(17)190531
Combination Product (y/n)N
Reporter Country CodeFR
PMA/PMN Number
P960058
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Foreign
Reporter Occupation Other
Type of Report Initial,Followup,Followup,Followup,Followup
Report Date 09/07/2021
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received09/28/2021
Is this an Adverse Event Report? Yes
Is this a Product Problem Report? No
Device Operator Lay User/Patient
Device Expiration Date05/31/2019
Device Model NumberCI-1500-04
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer01/31/2022
Is the Reporter a Health Professional? No
Was Device Evaluated by Manufacturer? Yes
Date Device Manufactured07/21/2016
Is the Device Single Use? Yes
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Initial
Patient Sequence Number1
Patient Outcome(s) Required Intervention;
Patient Age5 YR
Patient SexMale
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