FDA Adverse Event Injury Summary report: N

FLANGE FIXTURE AND ABUTMENT

MDR report key: 3031664 · Received April 2, 2013

Report

Report Number
6000034-2013-00578
Event Type
Injury
Date Received
April 2, 2013
Date of Event
March 18, 2013
Report Date
March 18, 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
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

(B)(4): IMPLANTED DEVICE REMAINS.

Description of Event or Problem · 1

PER THE CLINIC, THE PATIENT EXPERIENCED ABNORMAL SOUND QUALITY WITH DEVICE USE, AND THE ISSUE COULD NOT BE RESOLVED. THE IMPLANTED DEVICE REMAINS. THE PATIENT UNDERWENT REVISION SURGERY ON (B)(6) 2013, DURING WHICH THE ABUTMENT WAS REMOVED, AND THE PATIENT WAS IMPLANTED WITH A NEW FIXTURE AND ABUTMENT. IT WAS ALSO REPORTED THAT THE PATIENT RECEIVED IV ANTIBIOTICS DURING THE PROCEDURE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
135154 FLANGE FIXTURE AND ABUTMENT LXB LXB COCHLEAR BONE ANCHORED SOLUTIONS AB N/A 608586

Patients

Seq Age Sex Outcome Treatment
1 67 YR Required Intervention