FDA Adverse Event Injury Summary report: N

BIA400 IMPLANT 4MM W ABUTMENT 8MM

MDR report key: 7360447 · Received March 21, 2018

Report

Report Number
6000034-2018-00608
Event Type
Injury
Date Received
March 21, 2018
Report Date
March 5, 2018
Manufacturer
COCHLEAR BONE ANCHORED SOLUTIONS AB
Product Code
MAH
UDI-DI
09321502022705
PMA / PMN Number
K121317
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
PA, US
Reporter Occupation
HEALTH PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

THIS REPORT IS SUBMITTED ON MARCH 22, 2018, (B)(4).

Description of Event or Problem · 1

PER THE CLINIC, THE PATIENT EXPERIENCED A LOSS OF OSSEOINTEGRATION. CLINICAL MANAGEMENT IS ONGOING.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
201637 BIA400 IMPLANT 4MM W ABUTMENT 8MM COCHLEAR BAHA CONNECT SYSTEM MAH COCHLEAR BONE ANCHORED SOLUTIONS AB 93330 COH1080103 09321502022705

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention