ESTEEM 2001 902001-003

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a study report with the FDA on 2017-12-15 for ESTEEM 2001 902001-003 manufactured by Envoy Medical Corp..

Event Text Entries

[95052051]
Patient Sequence No: 1, Text Type: N, H10


[95052052] Sterile wound dehiscence. Wound dehiscence was surgically repaired on (b)(6) 2016. Sound processor, model 902001, serial number (b)(4), was replaced after becoming exposed due to a dehiscence of the incision. A new sound processor, sn (b)(4), was implanted during the repair surgery. Patient had undergone a battery change procedure on (b)(6) 2016, and the incision from that procedure did not heal properly. Patient history: (b)(6) 2008 - initial implant, (b)(6) 2008 - device turned on, (b)(6) 2008 - activation, (b)(6) 2008 - unscheduled fitting, (b)(6) 2008 - 2-month followup, (b)(6) 2008 - unscheduled fitting, (b)(6) 2008 - unscheduled fitting, (b)(6) 2008 - 4-month followup, (b)(6) 2008 - unscheduled fitting, (b)(6) 2009 - 10-month followup, (b)(6) 2012 - battery change, (b)(6) 2016 - battery change, (b)(6) 2016 - wound dehiscence repair.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number3004007782-2016-00006
MDR Report Key7123650
Report SourceSTUDY
Date Received2017-12-15
Date of Report2016-07-07
Date of Event2016-06-07
Date Mfgr Received2016-06-13
Device Manufacturer Date2016-06-13
Date Added to Maude2017-12-15
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer ContactMR. TODD KOEPPEL
Manufacturer Street4875 WHITE BEAR PARKWAY
Manufacturer CityWHITE BEAR LAKE MN 55110
Manufacturer CountryUS
Manufacturer Postal55110
Manufacturer Phone6513618057
Single Use3
Remedial ActionRP
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameESTEEM
Generic NameESTEEM II SP
Product CodeOAF
Date Received2017-12-15
Returned To Mfg2016-06-13
Model Number2001
Catalog Number902001-003
Lot NumberEMC0005871
Device Expiration Date2017-02-19
OperatorLAY USER/PATIENT
Device AvailabilityR
Device Eval'ed by MfgrY
Device Sequence No1
Device Event Key0
ManufacturerENVOY MEDICAL CORP.
Manufacturer Address4875 WHITE BEAR PARKWAY WHITE BEAR LAKE MN 55110 US 55110


Patients

Patient NumberTreatmentOutcomeDate
101. Required No Informationntervention 2017-12-15

© 2024 FDA.report
This site is not affiliated with or endorsed by the FDA.