| Brand Name | BIA400 IMPLANT 4MM W ABUTMENT 6MM |
| Common Device Name | COCHLEAR BAHA CONNECT SYSTEM |
| Manufacturer (Section D) |
| COCHLEAR BONE ANCHORED SOLUTIONS AB |
| konstruktionsvagen 14 |
| molnlycke, 435 3 3 |
| SW 435 33 |
|
| Manufacturer (Section G) |
| COCHLEAR BONE ANCHORED SOLUTIONS AB |
| konstruktionsvagen 14 |
|
| molnlycke, 435 3 3 |
|
SW
435 33
|
|
| Manufacturer Contact |
|
thevamalar
jayamagentharan
|
| unit ug-1, vertical podium |
| no. 8 jalan kerinchi, |
| kuala lumpur, wilayah persekutuan 59200
|
|
MY
59200
|
|
| MDR Report Key | 23971701 |
| Report Number | 6000034-2026-00075 |
| Device Sequence Number | 9012538 |
| Product Code |
MAH
|
| UDI-Device Identifier | 09321502022699 |
| UDI-Public | (01)09321502022699(10)138302(17)180831 |
| Combination Product (Y/N) | N |
| Initial Reporter State | WI |
| Initial Reporter Country | US |
| PMA/510(K) Number | K121317 |
| Number of Events Summarized | 1 |
| Summary Report (Y/N) | N |
| Device Implanted Year | 2018 |
| Serviced by Third Party (Y/N) | N |
| Reporter Type |
Manufacturer
|
| Report Source |
Health Professional |
| Initial Reporter Occupation |
Other
|
| Type of Report
| Initial |
| Report Date (Section B) |
01/06/2026 |
| 1 Device was Involved in the Event |
|
| 1 Patient was Involved in the Event |
|
| Is this an Adverse Event Report? |
Yes
|
| Is this a Product Problem Report? |
No
|
| Operator of Device |
Lay User/Patient
|
| Device Expiration Date | 08/31/2018 |
| Device Model Number | 93329 |
| Device Catalogue Number | 93329 |
| Device Lot Number | 138302 |
| Was Device Available for Evaluation? |
No
|
| Type of Report(Section G) | Initial |
| Initial Date Received by Manufacturer | 12/11/2026 |
| Initial Report FDA Received Date | 01/06/2026 |
| Was Device Evaluated by Manufacturer? (Y/N) |
No
|
| Is the Device Labeled for Single Use? (Y/N) |
Yes
|
Is This a Single-Use Device that was Reprocessed and Reused on a Patient? (Y/N) |
No
|
| Usage of Device |
Initial
|
| Patient Sequence Number | 1 |
| Outcome Attributed to Adverse Event |
Required Intervention;
|
| Patient Sex | Female |