FDA Adverse Event Injury Summary report: N

FLANGE FIXTURE AND ABUTMENT

MDR report key: 3201793 · Received July 2, 2013

Report

Report Number
6000034-2013-01172
Event Type
Injury
Date Received
July 2, 2013
Report Date
June 21, 2013
Manufacturer
COCHLEAR BONE ANCHORED SOLUTIONS AB
Product Code
LXB
PMA / PMN Number
K955713
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
MO, 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 WAS TAKEN TO THE OPERATING ROOM (DATE NOT REPORTED) FOR ABUTMENT EXCHANGE UNDER GENERAL ANESTHESIA. NO REPORTED SKIN REVISION DURING THIS PROCEDURE. THE IMPLANTED DEVICE REMAINS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
301017 FLANGE FIXTURE AND ABUTMENT LXB, PRODUCT CODE: LXB LXB COCHLEAR BONE ANCHORED SOLUTIONS AB 011CMC

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention