FDA Adverse Event Injury Summary report: N

SOFTFORM FACIAL IMPLANT

MDR report key: 227878 · Received June 18, 1999

Report

Report Number
2027148-1999-00072
Event Type
Injury
Date Received
June 18, 1999
Date of Event
November 2, 1998
Report Date
June 18, 1999
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

PATIENT IMPLANTED IN 1998 IN THE UPPER AND LOWER VERMILION BORDERS. ONSET OF INFECTION AND WOUND DRAINAGE 10/07/1998 IN PERIORAL. PATIENT TREATED WITH KEFLEX 10/07/1998, REVISED AND DEBRIDED 10/21/1998. IMPLANT EXPLANTED IN 1998.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 SOFTFORM FACIAL IMPLANT Implant SOFTFORM FTL TISSUE TECHNOLOGIES, INC NA K03874/98H081A

Patients

Seq Age Sex Outcome Treatment
1 37 YR Required Intervention 2. ZYDERM IMPLANT (TO 07/17/1998),| 3. KEFLEX (10/1998 TO 1998).| 1. ZYPLAST IMPLANT (TO 09/23/1998),