ESTEEM 2001 902001-002

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 2018-01-05 for ESTEEM 2001 902001-002 manufactured by Envoy Medical Corp..

Event Text Entries

[96638100] Device passed all manufacturing acceptance testing and quality inspection.
Patient Sequence No: 1, Text Type: N, H10


[96638101] Surgery to address retracted lead. On (b)(6) 2008 -original right ear implant by dr. (b)(6). On (b)(6) 2008-turn on. On (b)(6) 2008 -enhancement to reposition sensor. On (b)(6) 2008-turn on/ on (b)(6) 2008-activation. On (b)(6) 2008- 2 month follow up. On (b)(6) 2009- fitting. On (b)(6) 2009-unscheduled fitting. On (b)(6) 2010- enhancement, to recement the sensor after it was found touching the tm. On (b)(6) 2010- turn on. On (b)(6) 2010- fitting. On (b)(6) 2011- fitting. On (b)(6) 2011-sp removal for wound dehiscence healing. On (b)(6) 2011-new sp implanted; normal. On (b)(6) 2011- new sp implant, after finding inadequate lead insertion from (b)(6) implantation; normal the sp was tested and found to pass all requirements of the final mfg functional test. Additionally, investigation into bal seal springs indicated normal retention force.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number3004007782-2016-00011
MDR Report Key7170142
Report SourceSTUDY
Date Received2018-01-05
Date of Report2016-10-24
Date of Event2011-12-16
Date Mfgr Received2012-01-25
Date Added to Maude2018-01-05
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 ActionRL
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameESTEEM
Generic NameESTEEM II SP
Product CodeOAF
Date Received2018-01-05
Returned To Mfg2012-01-25
Model Number2001
Catalog Number902001-002
Lot NumberEMC0004291
Device Expiration Date2012-06-09
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 2018-01-05

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