BEUDAMED
    FDA Adverse Event Injury Summary report: N

    FLANGE FIXTURE AND ABUTMENT

    MDR report key: 3463839 · Received November 12, 2013

    Report

    Report Number
    6000034-2013-01967
    Event Type
    Injury
    Date Received
    November 12, 2013
    Date of Event
    October 24, 2013
    Report Date
    October 30, 2013
    Manufacturer
    COCHLEAR BONE ANCHORED SOLUTIONS AB
    Product Code
    LXB
    PMA / PMN Number
    K955713
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    WY, 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 IRRITATION AT THE ABUTMENT SITE AND WAS PRESCRIBED AUGMENTIN 875-125 MG ON (B)(6) 2013. THE IMPLANTED DEVICE REMAINS.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    581594 FLANGE FIXTURE AND ABUTMENT LXB, PRODUCT CODE: LXB LXB COCHLEAR BONE ANCHORED SOLUTIONS AB N/A 126757

    Patients

    Seq Age Sex Outcome Treatment
    1 69 YR Required Intervention