FDA Adverse Event Injury Summary report: N

FLANGE FIXTURE AND ABUTMENT

MDR report key: 3070770 · Received April 22, 2013

Report

Report Number
6000034-2013-00718
Event Type
Injury
Date Received
April 22, 2013
Date of Event
February 23, 2013
Report Date
May 23, 2013
Manufacturer
COCHLEAR BONE ANCHORED SOLUTIONS AB
Product Code
LXB
PMA / PMN Number
K955713
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
IA, US
Reporter Occupation
AUDIOLOGIST

Narratives

Additional Manufacturer Narrative · 1

(B)(4).

Additional Manufacturer Narrative · 1

CORRECTION: THE CORRECT CATALOG # US 92130; NOT 92127 AS PREVIOUSLY REPORTED. (B)(4).

Description of Event or Problem · 1

PER THE CLINIC, THE PATIENT UNDERWENT A SURGICAL PROCEDURE ON (B)(6) 2013, TO REMOVE EXCESS SKIN OVERGROWTH FROM AROUND THE ABUTMENT. IT WAS ADDITIONALLY REPORTED THAT THE PATIENT RECEIVED ANTIBIOTICS (TYPE NOT SPECIFIED.) THE IMPLANTED DEVICE REMAINS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
172923 FLANGE FIXTURE AND ABUTMENT LXB, PRODUCT CODE: LXB LXB COCHLEAR BONE ANCHORED SOLUTIONS AB 92127

Patients

Seq Age Sex Outcome Treatment
1 67 YR Required Intervention