BEUDAMED
    FDA Adverse Event Injury Summary report: N

    *

    MDR report key: 372192 · Received January 14, 2002

    Report

    Report Number
    372192
    Event Type
    Injury
    Date Received
    January 14, 2002
    Date of Event
    November 20, 2001
    Report Date
    January 10, 2002
    Manufacturer
    NA
    Product Code
    FWM
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    NE, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    REMOVAL OF RUPTURED BREAST IMPLANTS (RIGHT AND LEFT).

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 * * FWM NA NA NA

    Patients

    Seq Age Sex Outcome Treatment
    1 34 YR Hospitalization