FDA Adverse Event
Malfunction
Summary report: N
BREAST IMPLANT
MDR report key: 24581535
·
Received March 11, 2026
Report
- Report Number
- MW5185124
- Event Type
- Malfunction
- Date Received
- March 11, 2026
- Report Date
- March 10, 2026
- Manufacturer
- UNK
- Product Code
- FTR
- Product Problem
- 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 LEFT SIDE ¿REVISION¿ OF A NON-(B)(6) DEVICE. DEVICE WAS EXPLANTED. THIS REPORT REFLECTS INFORMATION RECEIVED BY FDA IN THE FORM OF A NOTIFICATION PER 803.22 (B)(2). PT CODE: 4582. DEVICE CODE: 4001. REF REPORT: MW5185125.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 637689 | BREAST IMPLANT | PROSTHESIS, BREAST, NONINFLATABLE, INTERNAL, SILICONE GEL-FILLED | FTR | UNK |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | NA | Unknown |