MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a company representative report with the FDA on 2019-05-13 for FLANGE FIXTURE 4MM SEC 002-0 N/A manufactured by Cochlear Bone Anchored Solutions Ab.
[144921562]
This report is submitted on may 14, 2019. (b)(4).
Patient Sequence No: 1, Text Type: N, H10
[144921563]
It was reported that the patient's device was electively explanted (date not reported) due to a traumatic injury. The patient will not be re-implanted with a new device.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 6000034-2019-00724 |
| MDR Report Key | 8606310 |
| Report Source | COMPANY REPRESENTATIVE |
| Date Received | 2019-05-13 |
| Date of Report | 2019-04-19 |
| Date Mfgr Received | 2019-04-19 |
| Date Added to Maude | 2019-05-13 |
| Event Key | 0 |
| Report Source Code | Manufacturer report |
| Manufacturer Link | Y |
| Number of Patients in Event | 0 |
| Adverse Event Flag | 3 |
| Product Problem Flag | 3 |
| Reprocessed and Reused Flag | 3 |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 3 |
| Event Location | 3 |
| Manufacturer Contact | MS. KRISTEL KOHNE |
| Manufacturer Street | 1 UNIVERSITY AVENUE |
| Manufacturer City | MACQUARIE UNIVERSITY, NSW 2109, |
| Manufacturer Country | AS |
| Manufacturer Postal | 2109, |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | FLANGE FIXTURE 4MM |
| Generic Name | NOBEL BIOCARE AB - PROSTHESIS |
| Product Code | FZE |
| Date Received | 2019-05-13 |
| Model Number | SEC 002-0 |
| Catalog Number | N/A |
| Lot Number | N/A |
| Operator | LAY USER/PATIENT |
| Device Availability | N |
| Device Eval'ed by Mfgr | R |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | COCHLEAR BONE ANCHORED SOLUTIONS AB |
| Manufacturer Address | KONSTRUKTIONSV?GEN 14 PO BOX 82 M?LNLYCKE, 435 22 SW 435 22 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 1. Required No Informationntervention | 2019-05-13 |