FDA Adverse Event Injury Summary report: N

BREAST IMPLANT (RIGHT)

MDR report key: 24331719 · Received February 12, 2026

Report

Report Number
MW5183747
Event Type
Injury
Date Received
February 12, 2026
Report Date
February 10, 2026
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. ((B)(6) REF (B)(4)). HEALTHCARE PROFESSIONAL REPORTED "CAPSULAR CONTRACTURE BAKER GRADE IV". LATER, HEALTHCARE PROFESSIONAL REPORTED "EXPLANTED DEVICE WAS A NON-ALLERGAN IMPLANT". THIS RECORD IS FOR THE RIGHT SIDE. DEVICE WAS EXPLANTED. DEVICE CODE: 2682. PATIENT CODE: 1761. THIS REPORT REFLECTS INFORMATION RECEIVED BY FDA IN THE FORM OF A NOTIFICATION PER 803.22 (B)(2). REFERENCE REPORT MW5183748.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
390689 BREAST IMPLANT (RIGHT) PROSTHESIS, BREAST, NONINFLATABLE, INTERNAL, SILICONE GEL-FILLED FTR UNKNOWN

Patients

Seq Age Sex Outcome Treatment
1 Unknown