COCHLEAR NUCLEUS IMPLANT RELIABILITY REPORT · Cochlear Nucleus Implant Reliability Report | December 2017 3 OUR MISSION We help people hear and be heard. We empower people to connect

C O C H L E A R ™ N U C L E U S ® I M P L A N TR E L I A B I L I T Y R E P O R T

Volume 16 | December 2017

3Cochlear Nucleus Implant Reliability Report | December 2017

OUR MISSION

We help people hear and be heard.

We empower people to connect with others and live a full life.

We transform the way people understand and treat hearing loss.

We innovate and bring to market a range of implantable hearing solutions that deliver a lifetime of hearing outcomes.

Cochlear’s implants are the most reliable1 in the industry*. That’s one reason why more people around the world choose Cochlear than any other cochlear implant brand.

* Latest generation of cochlear implants currently available as at 31 December 2017.

WHY RELIABILITY MATTERSHigh implant reliability means greater patient satisfaction and less risk of additional surgery. When considering a cochlear implant, it's important that you have access to the latest data on short- and long-term reliability, including success and failure rates for both adults and children.

ABOUT RELIABILITY REPORTINGThe global standards for cochlear implant reliability reporting are based on the reporting methodology recommended by International Standard ISO 5841-22,3, the reporting principles outlined in the European Consensus Statement on Cochlear Implant Failures and Explantations4, and expert recommendations from the International Classification of Reliability for Implanted Cochlear Implant Receiver Stimulators.5

This report meets the standards for cochlear implant reliability reporting outlined in the applicable standards referred to above.

COCHLEAR'S IMPLANTS ARE THE MOST RELIABLE 1

IN THE INDUSTRY*

* Latest generation of cochlear implants currently available as at 31 December 2017.


Cochlear Nucleus Implant Reliability Report | December 2017 Cochlear Nucleus Implant Reliability Report | December 2017 98

Nucleus Implant Reliability

REGISTERED IMPLANT DATA COMBINED FOR ADULTS AND CHILDREN AS OF 31 DECEMBER 2017

80

82

84

86

88

90

92

94

96

98

100

Cum

ulat

ive

Surv

ival

Per

cent

age

of Im

plan

ts

Time in Years

0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 302927 2825 26

Currently available implant Previously available implant

CI22M 91.40%

CI24M (ALL) 96.40%

CI24R 97.50%

CI500* 90.40%

CI24RE 99.00%

PROFILE 99.82%Number of registered implants - 31 December 2017

DEVICE ADULTS CHILDREN COMBINED

Profile 27,807 20,745 48,552

CI24RE 74,818 102,254 177,072

CI500 15,368 14,453 29,821

CI24R 18,671 34,709 53,380

CI24M (All) 7,858 11,873 19,731

CI22M 9,948 8,227 18,175

Cumulative Survival Percentage (CSP) data for combined adults and children

YEARS 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30

CI22M 99.2 98.7 98.2 97.8 97.5 97.2 96.9 96.7 96.5 96.2 96.0 95.7 95.5 95.2 95.0 94.8 94.7 94.4 94.2 93.9 93.6 93.4 93.2 92.8 92.5 92.3 92.2 92.1 91.9 91.4

CI24M (All) 99.4 98.9 98.4 98.2 98.0 97.9 97.8 97.6 97.5 97.3 97.2 97.1 97.1 97.0 97.0 96.9 96.8 96.8 96.7 96.6 96.4

CI24R 99.7 99.5 99.3 99.1 98.9 98.8 98.6 98.5 98.4 98.3 98.2 98.1 98.0 97.9 97.8 97.6 97.5 97.5

CI24RE 99.9 99.7 99.6 99.5 99.5 99.4 99.4 99.3 99.3 99.2 99.1 99.0 99.0

CI500 96.2 93.9 92.8 92.0 91.3 90.7 90.4 90.4 90.4

Profile 99.95 99.92 99.92 99.82

MORE PEOPLE CHOOSE COCHLEAR THAN ANY OTHER IMPLANT BRAND

* Voluntarily recalled in September 2011. Confidence intervals smaller than 0.1% may not be clearly visible in the graphs.

PROFILE 99.82% CSP WITHIN FOUR YEARS

CI24RE 99.00% CSP WITHIN 13 YEARS

OVER 345,000 REGISTERED COCHLEAR

NUCLEUS IMPLANTS WORLDWIDE

What is Cumulative Survival Percentage (CSP)?CSP is cumulative percentage of functioning implants over time, which indicates the reliability of the device within a given time period. In this report, CSP includes both device and accident-related issues.

The reliability calculations used in this report are in accordance with the International Standard ISO 5841-2.2,3 They are probability calculations, which use a modified Actuarial Analysis estimator. This data estimates the probability of survival within a period of time and is represented as CSP.

What data is in this report?

The data in this report covers the entire life of implant models and registered implants* worldwide.

How are results shown?Results for adults and children are shown separately with 95% confidence intervals ( ) as stipulated by the consensus statement.4

What is combined data?Combined data is the cumulative survival percentage of both adults and children populations combined.

HOW TO READ THIS REPORT

* An implant is registered with Cochlear when the recipient/clinic/hospital submits the registration of the implanted device. Implant registrations often lag behind surgery dates.

6 Cochlear Nucleus Implant Reliability Report | December 2017

CONSENSUS STATEMENT PRINCIPLES COCHLEAR REPORTING PRACTICE COCHLEAR COMPLIANCE

MED-EL COMPLIANCE6

ADVANCED BIONICS COMPLIANCE7

OTICON COMPLIANCE8

All device failures must be reported to the competent authority and must be included in the calculation of the Cumulative Survival Rate (CSR*). Reporting of the CSR should be in accordance with International Standard ISO 5841-2:2000.2

All device failures are reported to the competent authority.

Cochlear uses the calculation procedures of both ISO 5841-2:20002 and ISO 5841-2:2014.3

All device failure modes are included, including failures due to external impact.

Compliance with ISO 5841-22,3 not explicitly stated.

Manufacturer's reports of device failure should indicate the sources of data and the sample size. There must be no exclusions. The time period over which the data was collected should be specified.

The source of data is Cochlear’s global complaints handling database.

Sample size and time period are specified with each report. Sample size not included. Sample size not included.

Reports of CSR should give complete historical data of a given device, describing any technical modifications (which can be integrated into historical data by starting at time 0).

All models and all versions of each model are included in reports.

Descriptions of any significant technical modfications are given.

COMBI 40+ no longer reported.

PULSAR no longer reported.

Pre-2006 devices are no longer reported.

The complete data set of the ‘mother’** product should always be supplied when presenting data on subsequent device modifications.

Reports aggregate the reliability of all devices (pre- and post-modification). If the post-modification is significantly different, post-modification is reported separately from the aggregate of all devices.



A new device can be attributed when there has been a change in either the case and/or the electrodes and/or the electronics and has been labelled by its own CE mark.

A new device is attributed when there has been a change in either the case and/or the electrodes and/or the electronics and has been labelled by its own CE mark. Market practice is that all cochlear implants are labeled by one CE mark per authority.

Not explicitly stated. Not explicitly stated.

The CSR should be split into data for adults and for children and 95% confidence intervals (80% or 90% if the population is below 1,000 units) should be provided.

Reports show separate data for adults and children.

This Nucleus® Reliability Report contains reliability data with 95% confidence intervals, in compliance with the consensus statement.4

No split data on adults and children. Confidence intervals

not included.

No split data on adults and children.

Device survival time starts to count with closure of the wound intraoperatively.

Device survival time begins with closure of the wound.


* CSR is identical to Cumulative Survival Percentage (CSP).

** ‘Mother’ data refers to all data collected for a particular model of implant

including all modifications to that model.

In 2005, the major European cochlear implant centres, global regulatory authorities and device manufacturers developed the European Consensus Statement on Cochlear Implant Failures and Explantations.4 The consensus statement outlines how device failures and reliability should be reported, and the seven principles of best practice reporting.

COMPLIANCE WITH INTERNATIONAL REPORTING STANDARDS


CONSENSUS STATEMENT PRINCIPLES COCHLEAR REPORTING PRACTICE COCHLEAR COMPLIANCE

MED-EL COMPLIANCE6

ADVANCED BIONICS COMPLIANCE7

OTICON COMPLIANCE8

All device failures must be reported to the competent authority and must be included in the calculation of the Cumulative Survival Rate (CSR*). Reporting of the CSR should be in accordance with International Standard ISO 5841-2:2000.2

All device failures are reported to the competent authority.

Cochlear uses the calculation procedures of both ISO 5841-2:20002 and ISO 5841-2:2014.3

All device failure modes are included, including failures due to external impact.

Compliance with ISO 5841-22,3 not explicitly stated.

Manufacturer's reports of device failure should indicate the sources of data and the sample size. There must be no exclusions. The time period over which the data was collected should be specified.

The source of data is Cochlear’s global complaints handling database.

Sample size and time period are specified with each report. Sample size not included. Sample size not included.

Reports of CSR should give complete historical data of a given device, describing any technical modifications (which can be integrated into historical data by starting at time 0).

All models and all versions of each model are included in reports.

Descriptions of any significant technical modfications are given.



Pre-2006 devices are no longer reported.

The complete data set of the ‘mother’** product should always be supplied when presenting data on subsequent device modifications.

Reports aggregate the reliability of all devices (pre- and post-modification). If the post-modification is significantly different, post-modification is reported separately from the aggregate of all devices.



A new device can be attributed when there has been a change in either the case and/or the electrodes and/or the electronics and has been labelled by its own CE mark.

A new device is attributed when there has been a change in either the case and/or the electrodes and/or the electronics and has been labelled by its own CE mark. Market practice is that all cochlear implants are labeled by one CE mark per authority.


The CSR should be split into data for adults and for children and 95% confidence intervals (80% or 90% if the population is below 1,000 units) should be provided.

Reports show separate data for adults and children.

This Nucleus® Reliability Report contains reliability data with 95% confidence intervals, in compliance with the consensus statement.4

No split data on adults and children. Confidence intervals

not included.

No split data on adults and children.

Device survival time starts to count with closure of the wound intraoperatively.

Device survival time begins with closure of the wound.


* CSR is identical to Cumulative Survival Percentage (CSP).

** ‘Mother’ data refers to all data collected for a particular model of implant

including all modifications to that model.


Number of registered implants - 31 December 2017

DEVICE ADULTS CHILDREN COMBINED

Profile 27,807 20,745 48,552

CI24RE 74,818 102,254 177,072

CI500 15,368 14,453 29,821

CI24R 18,671 34,709 53,380

CI24M (All) 7,858 11,873 19,731

CI22M 9,948 8,227 18,175

Cumulative Survival Percentage (CSP) data for combined adults and children

YEARS 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30

CI22M 99.2 98.7 98.2 97.8 97.5 97.2 96.9 96.7 96.5 96.2 96.0 95.7 95.5 95.2 95.0 94.8 94.7 94.4 94.2 93.9 93.6 93.4 93.2 92.8 92.5 92.3 92.2 92.1 91.9 91.4

CI24M (All) 99.4 98.9 98.4 98.2 98.0 97.9 97.8 97.6 97.5 97.3 97.2 97.1 97.1 97.0 97.0 96.9 96.8 96.8 96.7 96.6 96.4

CI24R 99.7 99.5 99.3 99.1 98.9 98.8 98.6 98.5 98.4 98.3 98.2 98.1 98.0 97.9 97.8 97.6 97.5 97.5

CI24RE 99.9 99.7 99.6 99.5 99.5 99.4 99.4 99.3 99.3 99.2 99.1 99.0 99.0

CI500 96.2 93.9 92.8 92.0 91.3 90.7 90.4 90.4 90.4

Profile 99.95 99.92 99.92 99.82

MORE PEOPLE CHOOSE COCHLEAR THAN ANY OTHER IMPLANT BRAND

OVER 345,000 REGISTERED COCHLEAR

NUCLEUS IMPLANTS WORLDWIDE


Nucleus Implant Reliability

REGISTERED IMPLANT DATA COMBINED FOR ADULTS AND CHILDREN AS OF 31 DECEMBER 2017

80

82

84

86

88

90

92

94

96

98

100

Cum

ulat

ive

Surv

ival

Per

cent

age

of Im

plan

ts

Time in Years

0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 302927 2825 26

Currently available implant Previously available implant

CI22M 91.40%

CI24M (ALL) 96.40%

CI24R 97.50%

CI500* 90.40%

CI24RE 99.00%

PROFILE 99.82%

* Voluntarily recalled in September 2011. Confidence intervals smaller than 0.1% may not be clearly visible in the graphs.CSP includes both device and accident-related issues.

PROFILE 99.82% CSP WITHIN FOUR YEARS

CI24RE 99.00% CSP WITHIN 13 YEARS


CURRENTLY AVAILABLE IMPLANTS


NUCLEUS PROFILE SERIES IMPLANT

Number of registered Profile Series implants - 31 December 2017

ADULTS CHILDREN COMBINED

27,807 20,745 48,552

At only 3.9 mm, the thin implant body of the Profile Series is the most discreet choice for all patients.

Commercially released in 2014, the Profile Series sets a new standard in implant reliability with a 99.82% combined Cumulative Survival Percentage within four years.

Profile Series Cumulative Survival Percentage

YEAR 1 2 3 4

Adults 99.98 99.94 99.94 99.94

Children 99.92 99.88 99.88 99.66

Combined 99.95 99.92 99.92 99.82

3.9 mm


Adults Children

80

82

84

86

88

90

92

94

96

98

100

Profile Series Reliability

Time in Years

0 4321

Cum

ulat

ive

Surv

ival

Per

cent

age

of Im

plan

ts

REGISTERED IMPLANT DATA FOR ADULTS AND CHILDREN AS OF 31 DECEMBER 2017

ADULTS 99.94%CHILDREN 99.66%

PROFILE: OVER 48,000 DEVICES

IMPLANTED 99.82% COMBINED CSP

WITHIN FOUR YEARS

Confidence intervals smaller than 0.1% may not be clearly visible in the graphs.CSP includes both device and accident-related issues.


NUCLEUS CI24RE SERIES IMPLANT

Number of registered CI24RE Series implants - 31 December 2017


74,818 102,254 177,072

The CI24RE Series is the world’s most widely used cochlear implant.

Released in 2005, it has a 99.00% combined Cumulative Survival Percentage within 13 years.

CI24RE Series Cumulative Survival Percentage

YEARS 1 2 3 4 5 6 7 8 9 10 11 12 13

Adults 99.9 99.8 99.7 99.7 99.6 99.6 99.5 99.5 99.5 99.4 99.4 99.3 99.3

Children 99.8 99.7 99.5 99.4 99.4 99.3 99.2 99.2 99.1 99.0 98.8 98.7 98.7

Combined 99.9 99.7 99.6 99.5 99.5 99.4 99.4 99.3 99.3 99.2 99.1 99.0 99.0


CI24RE Series Reliability

Time in Years

0 1 2 3 4 5 6 7 8 9 10 1513 14121180

82

84

86

88

90

92

94

96

98

100

Cum

ulat

ive

Surv

ival

Per

cent

age

of Im

plan

ts


Adults Children

ADULTS 99.3%

CHILDREN 98.7%

CI24RE: OVER 177,000 DEVICES

IMPLANTED 99.00% CSP WITHIN

13 YEARS



17PREVIOUSLY AVAILABLE IMPLANTS


NUCLEUS CI500 SERIES IMPLANT

Number of registered CI500 Series implants - 31 December 2017


15,368 14,453 29,821

Released in 2009, the CI500 Series has a combined Cumulative Survival Percentage of 90.4% within nine years.

The CI500 Series was voluntarily recalled in September 2011.

CI500 Series Cumulative Survival Percentage

YEARS 1 2 3 4 5 6 7 8 9

Adults 95.9 93.9 92.8 92.2 91.7 91.2 90.9 90.9 90.9

Children 96.6 94.0 92.7 91.7 90.9 90.2 89.9 89.9 89.9

Combined 96.2 93.9 92.8 92.0 91.3 90.7 90.4 90.4 90.4


80

82

84

86

88

90

92

94

96

98

100

CI500 Series Reliability

Time in Years

0 1 2 3 4 5 109876

Cum

ulat

ive

Surv

ival

Per

cent

age

of Im

plan

ts


Adults Children

ADULTS 90.9%

CHILDREN 89.9%



NUCLEUS CI24R IMPLANT

Number of registered CI24R implants - 31 December 2017


18,671 34,709 53,380

The CI24R was released in 2000 with perimodiolar (Contour Advance®) and straight electrodes.

Within 18 years, the CI24R implant has a combined Cumulative Survival Percentage of 97.5%.

CI24R Cumulative Survival Percentage

YEARS 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18

Adults 99.8 99.6 99.5 99.4 99.2 99.1 99.0 98.9 98.8 98.7 98.7 98.6 98.6 98.5 98.4 98.3 98.3 98.3

Children 99.7 99.4 99.1 99.0 98.8 98.6 98.4 98.2 98.1 98.0 97.9 97.8 97.7 97.5 97.4 97.2 97.0 97.0

Combined 99.7 99.5 99.3 99.1 98.9 98.8 98.6 98.5 98.4 98.3 98.2 98.1 98.0 97.9 97.8 97.6 97.5 97.5


CI24R Reliability

Time in Years

0 1 2 3 4 5 6 7 8 9 10 11 12 1413 171615 18 19 20

Cum

ulat

ive

Surv

ival

Per

cent

age

of Im

plan

ts


Adults Children

80

82

84

86

88

90

92

94

96

98

100ADULTS 98.3%

CHILDREN 97.0%



NUCLEUS CI24M IMPLANT

Number of registered CI24M implants - 31 December 2017


ALL 7,858 11,873 19,731

POST** 6,154 9,350 15,504

Released in 1997, the CI24M implant was the world’s first cochlear implant with a removable magnet for MRI safety.

Within 21 years, the CI24M implant has a combined Cumulative Survival Percentage of 96.4%.

CI24M Cumulative Survival Percentage

YEARS 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21

Adults (All)

99.8 99.7 99.7 99.6 99.5 99.5 99.4 99.3 99.3 99.2 99.1 99.0 99.0 98.9 98.9 98.8 98.8 98.7 98.6 98.4 98.4

Children (All)

99.2 98.3 97.6 97.3 97.0 96.8 96.6 96.5 96.3 96.1 96.0 95.9 95.8 95.8 95.7 95.7 95.6 95.5 95.4 95.4 95.2

Combined (All)

99.4 98.9 98.4 98.2 98.0 97.9 97.8 97.6 97.5 97.3 97.2 97.1 97.1 97.0 97.0 96.9 96.8 96.8 96.7 96.6 96.4

Adults (Post)

99.8 99.7 99.7 99.6 99.5 99.5 99.4 99.3 99.2 99.2 99.0 99.0 99.0 98.9 98.9 98.8 98.8 98.8 98.7 # #

Children (Post)

99.4 98.6 98.1 97.8 97.5 97.4 97.2 97.0 96.8 96.7 96.5 96.5 96.4 96.3 96.3 96.2 96.2 96.1 95.9 95.9 #

Combined (Post)

99.5 99.1 98.7 98.5 98.3 98.2 98.1 97.9 97.8 97.7 97.5 97.5 97.4 97.4 97.3 97.3 97.2 97.1 97.0 97.0 #

** ‘Post’ refers to the addition of a structural support component to improve impact strength. # Individual populations are less than the minimum required for a valid calculation.3


CI24M Reliability

Time in Years

0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 2319 2120 221880

82

84

86

88

90

92

94

96

98

100

Cum

ulat

ive

Surv

ival

Per

cent

age

of Im

plan

ts


Children (Post)Adults (All)Adults (Post) Children (All)

CHILDREN (POST) 95.9%

CHILDREN (ALL) 95.2%

ADULTS (POST) 98.7%

ADULTS (ALL) 98.4%



NUCLEUS CI22M IMPLANT

Number of registered CI22M implants - 31 December 2017


9,948 8,227 18,175

Released in 1985, the CI22M implant was the first commercially available multi-channel cochlear implant in the world.

Within 30 years, the CI22M implant has a combined Cumulative Survival Percentage of 91.4%.

CI22M Cumulative Survival Percentage

YEARS 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

Adults 99.3 98.9 98.7 98.5 98.4 98.2 98.1 98.0 97.9 97.6 97.5 97.4 97.2 96.9 96.7

Children 99.2 98.3 97.6 96.9 96.5 96.0 95.5 95.2 94.8 94.5 94.2 93.8 93.5 93.3 92.9

Combined 99.2 98.7 98.2 97.8 97.5 97.2 96.9 96.7 96.5 96.2 96.0 95.7 95.5 95.2 95.0

16 17 18 19 20 21 22 23 24 25 26 27 28 29 30

96.6 96.4 96.2 96.0 95.8 95.6 95.3 95.2 94.8 94.4 94.3 94.2 94.1 94.0 93.5

92.8 92.6 92.4 92.0 91.7 91.4 91.2 90.9 90.6 90.4 90.0 89.9 89.7 89.3 #

94.8 94.7 94.4 94.2 93.9 93.6 93.4 93.2 92.8 92.5 92.3 92.2 92.1 91.9 91.4

# Individual populations are less than the minimum required for a valid calculation.3


CI22M Reliability

Time in Years

0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 30292827262580

82

84

86

88

90

92

94

96

98

100


Cum

ulat

ive

Surv

ival

Per

cent

age

of Im

plan

ts

Adults Children

CHILDREN 89.3%

ADULTS 93.5%



APPENDIXGRAPHICAL REPRESENTATIONEach graph represents a type of device based on the receiver/stimulator portion.

RECEIVER/ STIMULATOR

IMPLANTS*

Profile Series

Cochlear Nucleus Profile with Contour Advance Electrode (CI512)Cochlear Nucleus Profile with Slim Straight Electrode (CI522)Cochlear Nucleus Profile with Slim Modiolar Electrode (CI532)Cochlear Nucleus Profile Auditory Brainstem Implant (ABI541)

CI24RE Series

Nucleus Freedom® with Contour Advance ElectrodeNucleus Freedom with Straight ElectrodeCochlear Nucleus CI422 Cochlear ImplantCochlear Hybrid™ L24 Cochlear Implant

CI500 Series

Cochlear Nucleus CI512 Cochlear ImplantCochlear Nucleus CI513 Cochlear ImplantCochlear Nucleus CI551 Double Array Cochlear ImplantCochlear Nucleus ABI541 Auditory Brainstem Implant

CI24RNucleus 24 with Contour Advance ElectrodeNucleus 24 with Contour® ElectrodeNucleus 24k with Straight Electrode

CI24MNucleus 24 with Straight ElectrodeNucleus 24 with Double ArrayNucleus 24 Auditory Brainstem Implant [ABI]

CI22M Nucleus 22

* Implant availability varies by market.

Cochlear Nucleus Implant Reliability Report | December 2017

REFERENCES1. Cochlear Limited, 454378. Comparison of reliability of cochlear implants commercially available (as at 31 December 2017).

Data on file.

2. International Standard ISO 5841-2. Implants for Surgery — Cardiac Pacemakers — Part 2: Reporting of Clinical Performance of Populations of Pulse Generators or Leads. Geneva (Switzerland): International Organization for Standardization. 2000.

3. International Standard ISO 5841-2. Implants for Surgery — Cardiac Pacemakers — Part 2: Reporting of Clinical Performance of Populations of Pulse Generators or Leads. Geneva (Switzerland): International Organization for Standardization. 2014.

4. European Consensus Statement on Cochlear Implant Failures and Explantations. Otol Neurotol. 2005 Nov;26(6):1097-9.

5. Battmer RD, Backous DD, Balkany TJ, Briggs RJ, Gantz BJ, van Hasselt A, et al. International Classification of Reliability for Implanted Cochlear Implant Receiver Stimulators. Otol Neurotol. 2010 Oct;31(8):1190-3.

6. Cochlear Implant Reliability | MED-EL [Internet]. Medel.com. 2018 [cited 6 April 2018]. Available from: http://www.medel.com/reliability-reporting/

7. 2017 Global Implant Reliability Report. 027-N025-02. Advanced Bionics AG and affiliates.; 2017.

8. Oticon Medical Reliability Report H1 2017. Oticon Medical; 2017.

As the global leader in implantable hearing solutions, Cochlear is dedicated to bringing the gift of sound to people with moderate to profound hearing loss. We have helped over 450,000 people of all ages live full and active lives by reconnecting them with family, friends and community.

We aim to give our recipients the best lifelong hearing experience and access to innovative future technologies. For our professional partners, we offer the industry's largest clinical, research and support networks.

That’s why more people choose Cochlear than any other hearing implant company.

Cochlear Ltd (ABN 96 002 618 073) 1 University Avenue, Macquarie University, NSW 2109, Australia Tel: +61 2 9428 6555 Fax: +61 2 9428 6352Cochlear Ltd (ABN 96 002 618 073) 14 Mars Road, Lane Cove, NSW 2066, Australia Tel: +61 2 9428 6555 Fax: +61 2 9428 6352Cochlear Americas 13059 E Peakview Avenue, Centennial, CO 80111, USA Tel: +1 303 790 9010 Fax: +1 303 792 9025Cochlear Canada Inc 2500-120 Adelaide Street West, Toronto, ON M5H 1T1, Canada Tel: +1 416 972 5082 Fax: +1 416 972 5083Cochlear AG EMEA Headquarters, Peter Merian-Weg 4, 4052 Basel, Switzerland Tel: +41 61 205 0404 Fax: +41 61 205 0405 Cochlear Deutschland GmbH & Co. KG Karl-Wiechert-Allee 76A, 30625 Hannover, Germany Tel: +49 511 542 770 Fax: +49 511 542 7770Cochlear Europe Ltd 6 Dashwood Lang Road, Bourne Business Park, Addlestone, Surrey KT15 2HJ, United Kingdom Tel: +44 1932 26 3400 Fax: +44 1932 26 3426Cochlear Benelux NV Schaliënhoevedreef 20 i, B-2800 Mechelen, Belgium Tel: +32 15 79 55 11 Fax: +32 15 79 55 70Cochlear France S.A.S. 135 Route de Saint-Simon, 31100 Toulouse, France Tel: +33 5 34 63 85 85 (International) or 0805 200 016 (National) Fax: +33 5 34 63 85 80Cochlear Italia S.r.l. Via Larga 33, 40138 Bologna, Italy Tel: +39 051 601 53 11 Fax: +39 051 39 20 62Cochlear Nordic AB Konstruktionsvägen 14, 435 33 Mölnlycke, Sweden Tel +46 31 335 14 61 Fax +46 31 335 14 60Cochlear Tıbbi Cihazlar ve Sağlık Hizmetleri Ltd. Şti. Çubuklu Mah. Boğaziçi Cad., Boğaziçi Plaza No: 6/1, Kavacık, TR-34805 Beykoz-Istanbul, Turkey Tel: +90 216 538 5900 Fax: +90 216 538 5919Cochlear (HK) Limited Room 1204, 12/F, CRE Building, No 303 Hennessy Road, Wanchai, Hong Kong SAR Tel: +852 2530 5773 Fax: +852 2530 5183Cochlear Korea Ltd 1st floor, Cheongwon building, 828-5, Yuksam dong, Kangnam gu, Seoul, Korea Tel: +82 2 533 4663 Fax: +82 2 533 8408Cochlear Limited (Singapore Branch) 6 Sin Ming Road, #01-16 Sin Ming Plaza Tower 2, Singapore 575585 Tel: +65 6553 3814 Fax: +65 6451 4105Cochlear Medical Device (Beijing) Co., Ltd Unit 2208 Gemdale Tower B, 91 Jianguo Road, Chaoyang District, Beijing 100022, P.R. China Tel: +86 10 5909 7800 Fax: +86 10 5909 7900Cochlear Medical Device Company India Pvt. Ltd. Ground Floor, Platina Building, Plot No C-59, G-Block, Bandra Kurla Complex, Bandra (E), Mumbai – 400 051, India Tel: +91 22 6112 1111 Fax: +91 22 6112 1100株式会社日本コクレア（Nihon Cochlear Co Ltd）〒113-0033 東京都文京区本郷2-3-7 お茶の水元町ビル Tel: +81 3 3817 0241 Fax: +81 3 3817 0245Cochlear Middle East FZ-LLC Dubai Healthcare City, Al Razi Building 64, Block A, Ground Floor, Offices IR1 and IR2, Dubai, United Arab Emirates Tel: +971 4 818 4400 Fax: +971 4 361 8925Cochlear Latinoamérica S.A. International Business Park, Building 3835, Office 103, Panama Pacifico, Panama Tel: +507 830 6220 Fax: +507 830 6218Cochlear NZ Limited Level 4, Takapuna Towers, 19-21 Como St, Takapuna, Auckland 0622, New Zealand Tel: + 64 9 914 1983 Fax: +61 2 8002 2800

www.cochlear.com

Please seek advice from your medical practitioner or health professional about treatments for hearing loss. They will be able to advise you on a suitable solution for your hearing loss condition. All products should be used only as directed by your medical practitioner or health professional.

Not all products are available in all countries. Please contact your local Cochlear representative.

ACE, Advance Off-Stylet, AOS, AutoNRT, Autosensitivity, Beam, Button, CareYourWay, Carina, Cochlear, , , Cochlear SoftWear, Codacs, ConnectYourWay, Contour, Contour Advance, Custom Sound, ESPrit, Freedom, Hear now. And always, HearYourWay, Hugfit, Hybrid, Invisible Hearing, Kanso, MET, MicroDrive, MP3000, myCochlear, mySmartSound, NRT, Nucleus, Off-Stylet, Slimline, SmartSound, Softip, SPrint, True Wireless, the elliptical logo, WearYourWay and Whisper are either trademarks or registered trademarks of Cochlear Limited. Ardium, Baha, Baha SoftWear, BCDrive, DermaLock, EveryWear, Vistafix, and WindShield are either trademarks or registered trademarks of Cochlear Bone Anchored Solutions AB.

© Cochlear Limited 2018. D1335113 ISS2 MAY18

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Documents

COCHLEAR NUCLEUS IMPLANT RELIABILITY REPORT · Cochlear Nucleus Implant Reliability Report | December 2017 3 OUR MISSION We help people hear and be heard. We empower people to connect