FDA Adverse Event Injury Summary report: N

SIENTRA SILICONE GEL-FILLED BREAST IMPLANT

MDR report key: 3954658 · Received July 18, 2014

Report

Report Number
1651189-2014-00024
Event Type
Injury
Date Received
July 18, 2014
Date of Event
March 1, 2014
Report Date
July 17, 2014
Manufacturer
SIENTRA, INC
Product Code
FTR
PMA / PMN Number
P070004
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
PHYSICIAN

Narratives

Description of Event or Problem · 1

SILICONE GEL BREAST IMPLANT - PATIENT DIAGNOSED WITH BAKER GRADE IV CAPSULAR CONTRACTURE - LEFT SIDE. DEVICE REMOVED AND REPLACED WITH IDENTICAL DEVICE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
422115 SIENTRA SILICONE GEL-FILLED BREAST IMPLANT FTR SIENTRA, INC 20621

Patients

Seq Age Sex Outcome Treatment
1 44 YR