FDA Adverse Event Injury Summary report: N

ANATOMICAL DOUBLE CHAMBER TISSUE EXPANDER

MDR report key: 2912806 · Received January 8, 2013

Report

Report Number
1651189-2013-00002
Event Type
Injury
Date Received
January 8, 2013
Report Date
January 7, 2013
Manufacturer
SIENTRA, INC
Product Code
LCJ
PMA / PMN Number
K981852
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
PHYSICIAN

Narratives

Description of Event or Problem · 1

PHYSICIAN REPORTED LEAKAGE (STERILE SALINE) FROM BREAST TISSUE EXPANDER.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
10322 ANATOMICAL DOUBLE CHAMBER TISSUE EXPANDER LCJ SIENTRA, INC 20799

Patients

Seq Age Sex Outcome Treatment
1 Other