FDA Adverse Event Injury Summary report: N

FLANGE FIXTURE AND ABUTMENT

MDR report key: 3292041 · Received August 16, 2013

Report

Report Number
6000034-2013-01459
Event Type
Injury
Date Received
August 16, 2013
Report Date
August 20, 2013
Manufacturer
COCHLEAR BONE ANCHORED SOLUTIONS AB
Product Code
LXB
PMA / PMN Number
K955713
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
AUDIOLOGIST

Narratives

Additional Manufacturer Narrative · 1

(B)(4): IMPLANTED DEVICE REMAINS.

Additional Manufacturer Narrative · 1

PER THE SURGEON, THE PATIENT REPORTEDLY DEVELOPED AN INFECTION AROUND THE ABUTMENT SITE, AND THE SITE WAS SUBSEQUENTLY DEBRIDED ON (B)(6) 2013. ON (B)(6) 2013, THE ABUTMENT WAS REMOVED FROM THE FIXTURE. THIS REPORT IS FILED OCTOBER 23, 2013. IMPLANTED DEVICE REMAINS.

Description of Event or Problem · 1

PER THE CLINIC, ON (B)(6) 2013, THE PATIENT PRESENTED WITH EXPOSED BONE AROUND THE IMPLANT SITE. ADDITIONAL INFORMATION HAS BEEN REQUESTED BUT HAS NOT BEEN MADE AVAILABLE AS OF THE DATE OF THIS REPORT, (B)(6) 2013. THE IMPLANTED DEVICE REMAINS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
397419 FLANGE FIXTURE AND ABUTMENT LXB LXB COCHLEAR BONE ANCHORED SOLUTIONS AB N/A

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention