FDA Adverse Event Injury Summary report: N

SILTEX SALINE MAMMARY PROSTHESIS

MDR report key: 176702 · Received July 10, 1998

Report

Report Number
1645337-1998-00116
Event Type
Injury
Date Received
July 10, 1998
Report Date
August 21, 1997
Manufacturer
MENTOR
Product Code
FWM
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
TN, US
Reporter Occupation
PHYSICIAN

Narratives

Description of Event or Problem · 1

THE PT WAS IMPLANTED WITH A SILTEX SALINE MAMMARY PROSTHESIS ON 2/4/1995. SUBSEQUENTLY, THE PT EXPERIENCED PAIN IN HER BREAST. THE DEVICE WAS REMOVED ON 8/21/1997.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 SILTEX SALINE MAMMARY PROSTHESIS Implant MAMMARY PROSTHESIS FWM MENTOR NA NI

Patients

Seq Age Sex Outcome Treatment
1 46 YR Required Intervention