FDA Adverse Event Other Summary report: N

BREAST IMPLANT (RIGHT)

MDR report key: 24427788 · Received February 23, 2026

Report

Report Number
MW5184259
Event Type
Other
Date Received
February 23, 2026
Report Date
February 13, 2026
Manufacturer
UNKNOWN
Product Code
FTR
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 "CAPSULAR CONTRACTURE" OF A NON-(B)(6) DEVICE. THIS RECORD IS FOR THE LEFT SIDE. THE DEVICE WAS EXPLANTED. PATIENT CODE: 1761. DEVICE CODE: 4001. REFERENCE REPORT MW5184258. 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
473481 BREAST IMPLANT (RIGHT) PROSTHESIS, BREAST, NONINFLATABLE, INTERNAL, SILICONE GEL-FILLED FTR UNKNOWN

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown