FDA Adverse Event Injury Summary report: N

SOFTFORM FACIAL IMPLANT

MDR report key: 220217 · Received April 21, 1999

Report

Report Number
2027148-1999-00058
Event Type
Injury
Date Received
April 21, 1999
Date of Event
October 7, 1998
Manufacturer
TISSUE TECHNOLOGIES, INC.
Product Code
FTL
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
PHYSICIAN

Narratives

Description of Event or Problem · 1

PT IMPLANTED IN UPPER AND LOWER VERMILION BORDERS 08/01/1998. ONSET OF INFECTION AND IMPLANT EXTRUSION 08/28/1998. PT TREATED WITH CIPRO AND TYLENOL WITH CODEINE NO 3 ON 08/28/1998 WITH BACTROBAN 08/29/1998, WITH AUGMENTIN 500 ON 09/01/1998, WITH CEFTIN AND REVISED 09/02/1998. PT TREATED WITH AUGMENTIN 500 ON 09/16/1998 AND 09/21/1998, REVISED 09/21/1998 AND EXPLANTED AND TREATED WITH CIPRO ON 10/07/1998.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 SOFTFORM FACIAL IMPLANT Implant SOFTFORM FTL TISSUE TECHNOLOGIES, INC. NA K03784/98F281A

Patients

Seq Age Sex Outcome Treatment
1 49 YR Required Intervention KEFLEX (1998 TO 08/1998).