FDA Adverse Event
Injury
Summary report: N
BREAST IMPLANT
MDR report key: 23672139
·
Received November 28, 2025
Report
- Report Number
- MW5179486
- Event Type
- Injury
- Date Received
- November 28, 2025
- Report Date
- October 31, 2025
- Manufacturer
- UNKNOWN
- Product Code
- FTR
- Adverse Event
- Yes
- Report Source
- Voluntary report
- Reporter Location
- TX, US
- Reporter Occupation
- UNKNOWN
- Health Professional
- *
Narratives
Description of Event or Problem · 0
IN COMPLIANCE WITH MDR REPORTING REGULATION, SECTION 803.22, WE WISH TO INFORM YOU OF AN ADVERSE EVENT ASSOCIATED WITH ANOTHER MANUFACTURER'S DEVICE WHICH HAS BEEN RECEIVED AT ALLERGAN INC. (ABBVIE REF (B)(4). HEALTHCARE PROFESSIONAL REPORTED "RUPTURE" OF A NON-ABBVIE DEVICE. THIS RECORD IS FOR THE LEFT SIDE. DEVICE REMAINS IMPLANTED. THIS REPORT REFLECTS INFORMATION RECEIVED BY FDA IN THE FORM OF A NOTIFICATION PER 803.22 (B)(2).
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 2078899 | BREAST IMPLANT | PROSTHESIS, BREAST, NONINFLATABLE, INTERNAL, SILICONE GEL-FILLED | FTR | UNKNOWN |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | NA | Unknown |