BEUDAMED
    FDA Adverse Event Other Summary report: N

    PIP, INC.

    MDR report key: 223906 · Received April 26, 1999

    Report

    Report Number
    9681903-1999-00040
    Event Type
    Other
    Date Received
    April 26, 1999
    Date of Event
    February 12, 1999
    Report Date
    March 8, 1999
    Manufacturer
    PIP, INC.
    Product Code
    FWM
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    TN, US
    Reporter Occupation
    PHYSICIAN

    Narratives

    Description of Event or Problem · 1

    LEFT IMPLANT DEFLATED, REASON UNK.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 PIP, INC. Implant BREAST IMPLANT FWM PIP, INC. TEXTURED 96124

    Patients

    Seq Age Sex Outcome Treatment
    1 35 YR Other