BEUDAMED
    FDA Adverse Event Injury Summary report: N

    MENTOR

    MDR report key: 1060693 · Received June 10, 2008

    Report

    Report Number
    MW5007301
    Event Type
    Injury
    Date Received
    June 10, 2008
    Date of Event
    March 11, 2008
    Report Date
    June 10, 2008
    Product Code
    FWM
    Adverse Event
    Yes
    Report Source
    Voluntary report
    Reporter Location
    NV, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    BILATERAL BREAST REMOVE AND REPLACE IMPLANTS. BILATERAL RUPTURED IMPLANTS.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 MENTOR BREAST IMPLANTS FWM

    Patients

    Seq Age Sex Outcome Treatment
    1 35 YR