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