FDA Adverse Event Injury Summary report: N

SOFTFORM FACIAL IMPLANT

MDR report key: 242477 · Received September 27, 1999

Report

Report Number
2027148-1999-00176
Event Type
Injury
Date Received
September 27, 1999
Date of Event
April 27, 1999
Manufacturer
TISSUE TECHNOLOGIES, INC.
Product Code
FTL
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
AZ, US
Reporter Occupation
PHYSICIAN

Narratives

Description of Event or Problem · 1

PT IMPLANTED IN THE RIGHT AND LEFT UPPER VERMILION BORDERS. ONSET OF INFECTION 4/1/1999. PT TREATED WITH CEPHALEXIN 4/25/1999. THE IMPLANT WAS EXPLANTED AND THE PT TREATED WITH LEVAQUIN IN 1999.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 SOFTFORM FACIAL IMPLANT Implant SOFTFORM FTL TISSUE TECHNOLOGIES, INC. NA K04116/98K111A

Patients

Seq Age Sex Outcome Treatment
1 NO INFO Required Intervention