FDA Adverse Event Injury Summary report: N

FLANGE FIXTURE AND ABUTMENT

MDR report key: 2942612 · Received February 4, 2013

Report

Report Number
6000034-2013-00189
Event Type
Injury
Date Received
February 4, 2013
Date of Event
December 26, 2012
Report Date
August 21, 2013
Manufacturer
COCHLEAR BONE ANCHORED SOLUTIONS AB
Product Code
LXB
PMA / PMN Number
970051
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
CO
Reporter Occupation
AUDIOLOGIST

Narratives

Additional Manufacturer Narrative · 1

(B)(4)

Additional Manufacturer Narrative · 1

THIS FIXTURE/ABUTMENT IS NOT AVAILABLE FOR ANALYSIS.THIS REPORT IS FILED AUGUST 29, 2013.

Description of Event or Problem · 1

PER THE CLINIC, THE PATIENT EXPERIENCED A LOSS OF OSSEOINTEGRATION ON (B)(6) 2012, RESULTING IN FIXTURE LOSS. IT IS UNKNOWN IF THERE ARE PLANS TO REIMPLANT THE PATIENT WITH ANOTHER DEVICE AS OF THE DATE OF THIS REPORT, (B)(4) 2013.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
46841 FLANGE FIXTURE AND ABUTMENT PRODUCT CODE: LXB LXB COCHLEAR BONE ANCHORED SOLUTIONS AB 92346 122701

Patients

Seq Age Sex Outcome Treatment
1 21 YR Required Intervention