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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: COCHLEAR LTD CI612 COCHLEAR IMPLANT WITH CONTOUR ADVANCE ELECTRODE NUCLEUS 24 COCHLEAR IMPLANT SYSTEM

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COCHLEAR LTD CI612 COCHLEAR IMPLANT WITH CONTOUR ADVANCE ELECTRODE NUCLEUS 24 COCHLEAR IMPLANT SYSTEM Back to Search Results
Model Number CI612
Device Problems Electrical Lead/Wire (452); Migration (4003)
Patient Problem No Code Available (3191)
Event Date 07/14/2020
Event Type  Injury  
Manufacturer Narrative

This report is submitted on 5 august 2020.

 
Event Description

Per the clinic, the device was explanted on (b)(6) 2020 due to migration of the electrode array out of the cochlear. The patient was re-implanted with another cochlear device during the same surgery.

 
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Brand NameCI612 COCHLEAR IMPLANT WITH CONTOUR ADVANCE ELECTRODE
Type of DeviceNUCLEUS 24 COCHLEAR IMPLANT SYSTEM
Manufacturer (Section D)
COCHLEAR LTD
1 university avenue
macquarie university, nsw 2109
AS 2109
MDR Report Key10365438
MDR Text Key201660993
Report Number6000034-2020-01997
Device Sequence Number1
Product Code MCM
Combination Product (Y/N)N
Reporter Country CodeUS
Number of Events Reported1
Summary Report (Y/N)N
Report Source Distributor
Reporter Occupation
Type of Report Initial
Report Date 08/05/2020,07/15/2020
1 Device Was Involved in the Event
1 Patient Was Involved in the Event
Date FDA Received08/04/2020
Is This An Adverse Event Report? Yes
Is This A Product Problem Report? No
Device Operator LAY USER/PATIENT
Device MODEL NumberCI612
Was Device Available For Evaluation? No
Is The Reporter A Health Professional?
Was the Report Sent to FDA? Yes
Date Report Sent to FDA08/05/2020
Distributor Facility Aware Date07/15/2020
Event Location No Information
Was Device Evaluated By Manufacturer? No Answer Provided
Is The Device Single Use? No Answer Provided
Is this a Reprocessed and Reused Single-Use Device? No
Type of Device Usage

Patient TREATMENT DATA
Date Received: 08/04/2020 Patient Sequence Number: 1
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