FDA Adverse Event Injury Summary report: N

FLANGE FIXTURE AND ABUTMENT

MDR report key: 4112402 · Received September 24, 2014

Report

Report Number
6000034-2014-01368
Event Type
Injury
Date Received
September 24, 2014
Date of Event
September 3, 2014
Report Date
September 3, 2014
Manufacturer
COCHLEAR BONE ANCHORED SOLUTIONS AB
Product Code
LXB
PMA / PMN Number
K955713
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
AS
Reporter Occupation
HEALTH PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

(B)(4). DEVICE NOT RETURNED TO MANUFACTURER.

Description of Event or Problem · 1

PER THE CLINIC, THE PATIENT EXPERIENCED A LOSS OF OSSEOINTEGRATION RESULTING IN FIXTURE LOSS. THE PATIENT WAS REIMPLANTED WITH ANOTHER DEVICE ON (B)(6) 2014.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
593167 FLANGE FIXTURE AND ABUTMENT LXB LXB COCHLEAR BONE ANCHORED SOLUTIONS AB 95362

Patients

Seq Age Sex Outcome Treatment
1 75 YR Required Intervention