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..
[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
Report Number | 3004007782-2018-00003 |
MDR Report Key | 7462382 |
Report Source | HEALTH PROFESSIONAL |
Date Received | 2018-04-25 |
Date of Event | 2018-03-29 |
Date Mfgr Received | 2018-03-29 |
Device Manufacturer Date | 2012-07-01 |
Date Added to Maude | 2018-04-25 |
Event Key | 0 |
Report Source Code | Manufacturer report |
Manufacturer Link | Y |
Number of Patients in Event | 0 |
Adverse Event Flag | 3 |
Product Problem Flag | 3 |
Reprocessed and Reused Flag | 3 |
Health Professional | 3 |
Initial Report to FDA | 3 |
Report to FDA | 3 |
Event Location | 3 |
Manufacturer Contact | MR. TODD KOEPPEL |
Manufacturer Street | 4875 WHITE BEAR PARKWAY |
Manufacturer City | WHITE BEAR LAKE MN 55110 |
Manufacturer Country | US |
Manufacturer Postal | 55110 |
Manufacturer Phone | 6513618057 |
Single Use | 3 |
Remedial Action | RL |
Previous Use Code | 3 |
Event Type | 3 |
Type of Report | 3 |
Brand Name | ESTEEM |
Generic Name | ESTEEM II DRIVER |
Product Code | OAF |
Date Received | 2018-04-25 |
Returned To Mfg | 2018-04-04 |
Model Number | 7504 |
Catalog Number | 907504-003 |
Lot Number | EMC0004801 |
Device Expiration Date | 2014-07-01 |
Operator | LAY USER/PATIENT |
Device Availability | R |
Device Eval'ed by Mfgr | Y |
Device Sequence No | 1 |
Device Event Key | 0 |
Manufacturer | ENVOY MEDICAL CORP. |
Manufacturer Address | 4875 WHITE BEAR PARKWAY WHITE BEAR LAKE MN 55110 US 55110 |
Patient Number | Treatment | Outcome | Date |
---|---|---|---|
1 | 0 | 1. Required No Informationntervention | 2018-04-25 |