FDA Adverse Event Injury Summary report: N

FLANGE FIXTURE AND ABUTMENT

MDR report key: 3831319 · Received May 24, 2014

Report

Report Number
6000034-2014-00726
Event Type
Injury
Date Received
May 24, 2014
Report Date
May 7, 2014
Manufacturer
COCHLEAR BONE ANCHORED SOLUTIONS AB
Product Code
LXB
PMA / PMN Number
K955713
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
DE, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

(B)(4). THE IMPLANTED DEVICE REMAINS.

Description of Event or Problem · 1

PER THE CLINIC, THE PATIENT WAS ADMINISTERED A KENALOG INJECTION (DATE NOT REPORTED) DUE TO PAIN AND SKIN OVERGROWTH AT THE ABUTMENT SITE. THE IMPLANTED DEVICE REMAINS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
309657 FLANGE FIXTURE AND ABUTMENT LXB: PRODUCT CODE LXB COCHLEAR BONE ANCHORED SOLUTIONS AB

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention