FDA Adverse Event Injury Summary report: N

FLANGE FIXTURE AND ABUTMENT

MDR report key: 3831320 · Received May 24, 2014

Report

Report Number
6000034-2014-00764
Event Type
Injury
Date Received
May 24, 2014
Date of Event
April 24, 2014
Report Date
May 13, 2014
Manufacturer
COCHLEAR BONE ANCHORED SOLUTIONS AB
Product Code
LXB
PMA / PMN Number
K984162
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
NM, 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 PRESCRIBED ORAL ANTIBIOTICS ON (B)(6) 2014 DUE TO INFECTION AT THE IMPLANT SITE, SUBSEQUENT TO A PROCEDURE ON (B)(6), 2014 TO ACCESS THE FIXTURE SITE UNDER GENERAL ANESTHESIA TO PLACE A NEW ABUTMENT. THE IMPLANTED DEVICE REMAINS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
309682 FLANGE FIXTURE AND ABUTMENT LXB, PRODUCT CODE LXB COCHLEAR BONE ANCHORED SOLUTIONS AB 134189

Patients

Seq Age Sex Outcome Treatment
1 12 YR Required Intervention