ESTEEM 7500 907500-002

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 2018-01-15 for ESTEEM 7500 907500-002 manufactured by Envoy Medical Corp..

Event Text Entries

[97315055] Failure mode determined to be a design issue with leads manufactured by oscor. Issue was investigated under envoy medical capa (b)(4). Corrective action was to redesign the leads and manufacture in-house at envoy medical. Corrective action has proved effective.
Patient Sequence No: 1, Text Type: N, H10


[97315056] On (b)(6) 2017 - patient complained that device had stopped functioning. Patient had undergone a revision surgery on (b)(6) 2017. On (b)(6) 2006 - initial implant. On (b)(6) 2006 - activation and audiograms. On (b)(6) 2010 - battery change. On (b)(6) 2010 - fitting. On (b)(6) 2012 - fitting. On (b)(6) 2012 - analysis. On (b)(6) 2014 - fitting. On (b)(6) 2015 - aborted battery change. On (b)(6) 2015 - battery change. On (b)(6) 2017 - fitting. On (b)(6) 2017 - wound dehiscence revision surgery (mdr 3004007782-2017-00016). On (b)(6) 2017 - onset of device failure symptoms - expectation was that a lead had backed out of the sp. Revision surgery scheduled. On (b)(6) 2017 - revision surgery conducted for a backed out lead. However, leads were found to be fully inserted. Testing indicated that the driver appeared to be non-functional. Patient was not under proper anesthesia for a full revision and replacement surgery, so the patient was closed and another revision surgery was scheduled. On (b)(6) 2017 - revision surgery conduced. Entire system was explanted and replaced.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number3004007782-2017-00017
MDR Report Key7192199
Report SourceSTUDY
Date Received2018-01-15
Date of Report2018-01-05
Date of Event2017-11-14
Date Mfgr Received2018-01-15
Device Manufacturer Date2006-05-01
Date Added to Maude2018-01-15
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 ActionRL
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameESTEEM
Generic NameESTEEM II DRIVER
Product CodeOAF
Date Received2018-01-15
Returned To Mfg2018-01-15
Model Number7500
Catalog Number907500-002
Lot NumberEMC0001808
Device Expiration Date2008-05-01
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 2018-01-15

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