FDA Adverse Event Injury Summary report: N

BA400 ABUTMENT 6MM

MDR report key: 8485237 · Received April 4, 2019

Report

Report Number
6000034-2019-00462
Event Type
Injury
Date Received
April 4, 2019
Report Date
August 13, 2019
Manufacturer
COCHLEAR BONE ANCHORED SOLUTIONS AB
Product Code
LXB
PMA / PMN Number
K121317
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
NL
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 0

IT WAS REPORTED THAT THE PATIENT WAS TREATED WITH ORAL AND TOPICAL ANTIBIOTICS, A SKIN REDUCTION WAS ALSO PERFORMED (DATE NOT REPORTED). THIS REPORT IS SUBMITTED ON SEPTEMBER 04, 2019.

Additional Manufacturer Narrative · 1

THIS REPORT IS SUBMITTED ON APRIL 05, 2019. (B)(4).

Description of Event or Problem · 1

PER THE CLINIC, THE PATIENT EXPERIENCED INFECTION AT IMPLANT SITE; SUBSEQUENTLY THE PATIENT'S ABUTMENT WAS REPLACED (DATE NOT REPORTED).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
277868 BA400 ABUTMENT 6MM COCHLEAR BAHA CONNECT SYSTEM LXB COCHLEAR BONE ANCHORED SOLUTIONS AB 93333 ASKU

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention