FDA Adverse Event Injury Summary report: N

SOFTFORM FACIAL IMPLANT

MDR report key: 296244 · Received September 11, 2000

Report

Report Number
2027148-2000-00046
Event Type
Injury
Date Received
September 11, 2000
Date of Event
April 19, 2000
Report Date
September 11, 2000
Manufacturer
TISSUE TECHNOLOGIES, INC.
Product Code
FTL
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
WA, US
Reporter Occupation
PHYSICIAN

Narratives

Description of Event or Problem · 1

PT IMPLANTED 2000 IN THE UPPER LEFT VERMILION BORDER. ONSET OF INFECTION AND IMPLANT EXTRUSION 4/13/2000. PT TREATED 6/7/2000 WITH KEFLEX 4/13/2000. THE IMPLANT WAS EXPLANTED IN 2000.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 SOFTFORM FACIAL IMPLANT SOFTFORM FTL TISSUE TECHNOLOGIES, INC. NA K04485/00A401A

Patients

Seq Age Sex Outcome Treatment
1 29 YR Required Intervention BIRTH CONTROL PILLS.