BEUDAMED
    FDA Adverse Event Injury Summary report: N

    MENTOR

    MDR report key: 1060695 · Received June 10, 2008

    Report

    Report Number
    MW5007303
    Event Type
    Injury
    Date Received
    June 10, 2008
    Date of Event
    January 16, 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

    RIGHT BREAST CAPSULECTOMY.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 MENTOR BREAST IMPLANTS FWM 563-0835

    Patients

    Seq Age Sex Outcome Treatment
    1 53 YR