BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    BREAST IMPLANT

    MDR report key: 3035504 · Received April 6, 2006

    Report

    Report Number
    3035504
    Event Type
    Malfunction
    Date Received
    April 6, 2006
    Date of Event
    March 22, 2006
    Report Date
    March 30, 2006
    Manufacturer
    MENTOR
    Product Code
    FWM
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    AL, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    BREAST IMPLANT DEFLATED. (B)(6) 2006 10:57 AM (B)(6).

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 BREAST IMPLANT FWM MENTOR

    Patients

    Seq Age Sex Outcome Treatment
    1 43 YR