FDA Adverse Event Injury Summary report: N

FLANGE FIXTURE AND ABUTMENT

MDR report key: 3163013 · Received June 11, 2013

Report

Report Number
6000034-2013-01041
Event Type
Injury
Date Received
June 11, 2013
Date of Event
May 15, 2013
Report Date
March 3, 2014
Manufacturer
COCHLEAR BONE ANCHORED SOLUTIONS AB
Product Code
LXB
PMA / PMN Number
K955713
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
CO
Reporter Occupation
AUDIOLOGIST

Narratives

Additional Manufacturer Narrative · 1

PER THE SURGEON, THE PATIENT WAS REIMPLANTED WITH A NEW FIXTURE ON (B)(6) 2013. THIS REPORT IS FILED OCTOBER 17, 2013. DEVICE UNAVAILABLE AT THIS TIME.

Additional Manufacturer Narrative · 1

(B)(4).

Additional Manufacturer Narrative · 1

THIS REPORT IS FILED MARCH 4, 2014.

Description of Event or Problem · 1

PER THE CLINIC, THE PATIENT EXPERIENCED A LOSS OF OSSEOINTEGRATION ON (B)(4) 2013, 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)(6) 2013.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
262824 FLANGE FIXTURE AND ABUTMENT LXB LXB COCHLEAR BONE ANCHORED SOLUTIONS AB N/A 126193

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention