FDA Adverse Event Injury Summary report: N

FLANGE FIXTURE AND ABUTMENT

MDR report key: 3020274 · Received March 25, 2013

Report

Report Number
6000034-2013-00558
Event Type
Injury
Date Received
March 25, 2013
Report Date
May 7, 2013
Manufacturer
COCHLEAR BONE ANCHORED SOLUTIONS AB
Product Code
LXB
PMA / PMN Number
K955713
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
GA, US
Reporter Occupation
AUDIOLOGIST

Narratives

Additional Manufacturer Narrative · 1

(B)(4).THIS REPORT IS FILED JUNE 6, 2013. (B)(4): IMPLANTED DEVICE REMAINS.

Additional Manufacturer Narrative · 1

(B)(4). IMPLANTED DEVICE REMAINS.

Description of Event or Problem · 1

PER THE CLINIC, THE PATIENT UNDERWENT REVISION SURGERY (DATE NOT REPORTED), TO EXCISE AN OVERGROWTH OF SKIN TISSUE AROUND THE IMPLANT SITE. THE IMPLANTED DEVICE REMAINS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
122707 FLANGE FIXTURE AND ABUTMENT LXB LXB COCHLEAR BONE ANCHORED SOLUTIONS AB N/A N/A

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention