FDA Adverse Event Injury Summary report: N

FLANGE FIXTURE AND ABUTMENT

MDR report key: 2921114 · Received January 17, 2013

Report

Report Number
6000034-2013-00134
Event Type
Injury
Date Received
January 17, 2013
Report Date
February 6, 2014
Manufacturer
COCHLEAR BONE ANCHORED SOLUTIONS AB
Product Code
LXB
PMA / PMN Number
K955713
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
CA
Reporter Occupation
AUDIOLOGIST

Narratives

Additional Manufacturer Narrative · 1

(B)(4).

Additional Manufacturer Narrative · 1

THIS ABUTMENT IS NOT AVAILABLE FOR ANALYSIS. THIS REPORT IS FILED 28 MAR 2014.

Description of Event or Problem · 1

PER THE CLINIC, THE PATIENT EXPERIENCED CHRONIC INFECTION AT THE IMPLANT SITE. THE PATIENT WAS PRESCRIBED ANTIBIOTIC TREATMENT (AMOUNT AND TYPE NOT REPORTED) HOWEVER; THE ISSUE COULD NOT BE RESOLVED. THE PATIENT UNDERWENT A PROCEDURE TO HAVE THE ABUTMENT REMOVED (DATE NOT REPORTED). ADDITIONAL INFORMATION HAS BEEN REQUESTED BUT HAS NOT BEEN MADE AVAILABLE AS OF THE DATE OF THIS REPORT, (B)(6) 2013. THE IMPLANTED DEVICE REMAINS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
26898 FLANGE FIXTURE AND ABUTMENT PRODUCT CODE: LXB LXB COCHLEAR BONE ANCHORED SOLUTIONS AB

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention