FDA Adverse Event Injury Summary report: N

BREAST IMPLANT

MDR report key: 24115482 · Received January 20, 2026

Report

Report Number
MW5182461
Event Type
Injury
Date Received
January 20, 2026
Report Date
January 15, 2026
Manufacturer
UNK
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. ((B)(6) REF (B)(4)). ALLEGED EVENT: HEALTHCARE PROFESSIONAL REPORTED "RUPTURE" OF A NON-(B)(6) DEVICE. THIS RECORD IS FOR THE LEFT SIDE. THE DEVICE WAS EXPLANTED AND UNKNOWN IF IT WAS REPLACED. 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
173889 BREAST IMPLANT PROSTHESIS, BREAST, NONINFLATABLE, INTERNAL, SILICONE GEL-FILLED FTR UNK

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown