BEUDAMED
    FDA Adverse Event Injury Summary report: N

    UNK

    MDR report key: 2192964 · Received February 20, 2008

    Report

    Report Number
    2192964
    Event Type
    Injury
    Date Received
    February 20, 2008
    Date of Event
    December 26, 2007
    Report Date
    January 16, 2008
    Manufacturer
    UNK
    Product Code
    FWM
    Report Source
    User Facility report
    Reporter Location
    TX, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    BILATERAL SALINE BREAST IMPLANTS (RIGHT IMPLANT RUPTURE).

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 UNK UNK FWM UNK UNK UNK

    Patients

    Seq Age Sex Outcome Treatment
    1 64 YR Hospitalization