FDA Adverse Event Injury Summary report: N

SOFTFORM FACIAL IMPLANT

MDR report key: 196789 · Received November 12, 1998

Report

Report Number
2027148-1998-00109
Event Type
Injury
Date Received
November 12, 1998
Date of Event
April 3, 1998
Report Date
November 12, 1998
Manufacturer
TISSUE TECHNOLOGIES, INC
Product Code
FTL
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
NJ, US
Reporter Occupation
PHYSICIAN

Narratives

Description of Event or Problem · 1

PT IMPLANTED 03/20/1998 IN THE UPPER AND LOWER VERMILION BORDERS. ONSET OF INFECTION 04/02/1998. PT TREATED WITH CIPRO 04/02/1998. ON 04/03/1998 THE IMPLANT WAS EXPLANTED AND ICE APPLIED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 SOFTFORM FACIAL IMPLANT Implant SOFTFORM FTL TISSUE TECHNOLOGIES, INC NA K03500/97K231A

Patients

Seq Age Sex Outcome Treatment
1 45 YR Required Intervention MOTRIN (TO 03/20/1998)| KEFLEX (03/19/1998 TO 03/21/1998)