FDA Adverse Event
Injury
Summary report: N
BIA300 IMPLANT 4MM W ABUTMENT 6MM
MDR report key: 13022572
·
Received December 16, 2021
Report
- Report Number
- 6000034-2021-03761
- Event Type
- Injury
- Date Received
- December 16, 2021
- Date of Event
- September 13, 2021
- Report Date
- November 29, 2021
- Manufacturer
- COCHLEAR BONE ANCHORED SOLUTIONS AB
- Product Code
- LXB
- Adverse Event
- Yes
- Report Source
- Distributor report
- Reporter Location
- US
- Reporter Occupation
- OTHER HEALTH CARE PROFESSIONAL
- Health Professional
- Yes
Narratives
Additional Manufacturer Narrative · 0
THERE WAS NO REPORTED INFECTION. THIS REPORT IS SUBMITTED ON DEC 17, 2021.
Additional Manufacturer Narrative · 0
THIS REPORT IS SUBMITTED ON DEC 17, 2021.
Description of Event or Problem · 0
THERE WAS NO REPORTED INFECTION.
Description of Event or Problem · 0
PER THE CLINIC, THE PATIENT EXPERIENCED AN INFECTION (TREATMENT UNKNOWN) AT THE ABUTMENT SITE. THE CONNECT DEVICE WAS CONVERTED TO AN OSIA DEVICE ON (B)(6) 2021 I.E., THE ABUTMENT WAS REMOVED AND THE OSIA WAS PLACED ON THE EXISTING IMPLANT. FURTHER INFORMATION IS BEING SOUGHT FROM THE CLINIC.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1917072 | BIA300 IMPLANT 4MM W ABUTMENT 6MM | COCHLEAR BAHA CONNECT SYSTEM | LXB | COCHLEAR BONE ANCHORED SOLUTIONS AB | 92127 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 37 YR | Female | Required Intervention |