FDA Adverse Event Other Summary report: N

PIP, INC.

MDR report key: 223940 · Received April 26, 1999

Report

Report Number
9681903-1999-00042
Event Type
Other
Date Received
April 26, 1999
Date of Event
March 3, 1999
Report Date
March 8, 1999
Manufacturer
PIP, INC.
Product Code
FWM
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
AL, US
Reporter Occupation
PHYSICIAN

Narratives

Description of Event or Problem · 1

DEFLATION OF THE RIGHT BREAST IMPLANT, REASON UNK.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 PIP, INC. Implant BREAST IMPLANT FWM PIP, INC. TEXTURED 97257

Patients

Seq Age Sex Outcome Treatment
1 46 YR Other