ESTEEM 7504 907504-003

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a health professional report with the FDA on 2018-04-25 for ESTEEM 7504 907504-003 manufactured by Envoy Medical Corp..

Event Text Entries

[106578735] Device passed all manufacturing acceptance testing and quality inspection.
Patient Sequence No: 1, Text Type: N, H10


[106578736] (b)(6) 2018 - following the battery change surgery, it was determined that there was a problem with the esteem system and it was not functioning. (b)(6) 2018 - diagnostic testing was performed, but the cause of the issue could not be determined and a revision surgery was scheduled for the next day. (b)(6) 2018 - revision surgery found that the esteem driver was not functioning and it was replaced with successful results. Patient history: (b)(6) 2012 - patient was implanted with the esteem system. (b)(6) 2012 - activation; (b)(6) 2012 - fitting; (b)(6) 2013 - fitting; (b)(6) 2015 - fitting; (b)(6) 2018 - battery change surgery; (b)(6) 2018 - audio and esteem diagnostics; (b)(6) 2018 - transmastoid revision.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number3004007782-2018-00003
MDR Report Key7462382
Report SourceHEALTH PROFESSIONAL
Date Received2018-04-25
Date of Event2018-03-29
Date Mfgr Received2018-03-29
Device Manufacturer Date2012-07-01
Date Added to Maude2018-04-25
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 Received2018-04-25
Returned To Mfg2018-04-04
Model Number7504
Catalog Number907504-003
Lot NumberEMC0004801
Device Expiration Date2014-07-01
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 2018-04-25

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