FDA Adverse Event Injury Summary report: N

SOFTFORM FACIAL IMPLANT

MDR report key: 242486 · Received September 27, 1999

Report

Report Number
2027148-1999-00153
Event Type
Injury
Date Received
September 27, 1999
Date of Event
March 16, 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

PT IMPLANTED IN 1999 IN NASOLABIAL FOLDS. ONSET OF WOUND DRAINAGE 02/27/1999. PT TREATED WITH CEFTIN 03/02/1999, REVISED IN 1999. IMPLANT EXPLANTED IN 1999.

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 53 YR Required Intervention