MAUDE MDR 9881618

MDR report key
9881618
Report number
6000034-2020-00948
Event key
0
Event type
3
Date of event
2020-01-27
Date received
2020-03-25
Adverse event
3
Product problem
3
Patients in event
0
Reporter occupation
100
Health professional
3
Initial report to FDA
3
Event location
3

Manufacturer Contact#

Report source
D
Manufacturer link flag
N

Devices#

Seq, Brand, Generic table
SeqBrandGenericManufacturerProduct codeModelCatalogLotPMA510(k)ImplantEvaluatedAvailability
1FLANGE FIXTURE ST 4MMCOCHLEAR BAHA CONNECT SYSTEMCOCHLEAR BONE ANCHORED SOLUTIONS ABLXB9043290432NI* R

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
12020-03-2501. R

Event Narratives#

D

Patient 1

PER THE CLINIC, IT WAS REPORTED THAT THE PATIENT EXPERIENCED A LOSS OF OSSEOINTEGRATION RESULTING IN FIXTURE LOSS ON (B)(6) 2020. IT IS UNKNOWN WHETHER THERE ARE PLANS TO REIMPLANT THE PATIENT AS OF THE DATE OF THIS REPORT.