| Brand Name | HiRes¿ Ultra Implant |
| Common Device Name | Cochlear Implant |
| Manufacturer (Section D) |
| Advanced Bionics, LLC |
| 28515 westinghouse place |
| valencia CA 91355 |
|
| Manufacturer Contact |
|
lacey
o'linn
|
| 28515 westinghouse place |
| valencia, CA 91355
|
|
| MDR Report Key | 50671098 |
| Report Number | 3006556115-2026-01091 |
| Device Sequence Number | 21375882 |
| Product Code |
MCM
|
| UDI-Device Identifier | 07630016841002 |
| Combination Product (Y/N) | N |
| Initial Reporter Country | SP |
| PMA/510(K) Number | P960058 |
| Number of Events Summarized | 1 |
| Summary Report (Y/N) | N |
| Device Implanted Year | 2017 |
| Device Explanted Year | 2026 |
| Serviced by Third Party (Y/N) | N |
| Reporter Type |
Manufacturer
|
| Report Source |
Foreign,Health Professional |
| Initial Reporter Occupation |
Physician
|
| Type of Report
| Initial |
| Report Date (Section B) |
08/31/2026 |
| 1 Device was Involved in the Event |
|
| 1 Patient was Involved in the Event |
|
| Is this an Adverse Event Report? |
No
|
| Is this a Product Problem Report? |
Yes
|
| Operator of Device |
Lay User/Patient
|
| Device Expiration Date | 07/31/2020 |
| Device Model Number | CI-1600-04 |
| Was Device Available for Evaluation? |
No
|
| Is the Reporter a Health Professional? |
Yes
|
| Type of Report(Section G) | Thirty-Day |
| Initial Date Received by Manufacturer | 08/31/2026 |
| Initial Report FDA Received Date | 09/08/2026 |
| Was Device Evaluated by Manufacturer? (Y/N) |
Device Not Returned to Manufacturer
|
| Date Device Manufactured | 08/07/2017 |
| Is the Device Labeled for Single Use? (Y/N) |
Yes
|
Is This a Single-Use Device that was Reprocessed and Reused on a Patient? (Y/N) |
No
|
| Usage of Device |
Initial
|
| Patient Sequence Number | 1 |
| Patient Sex | Female |
|
|