BEUDAMED
    FDA Adverse Event Injury Summary report: N

    MEMORYSHAPE (SILICONE) SILTEX MEDIUM HEIGHT

    MDR report key: 5008441 · Received August 10, 2015

    Report

    Report Number
    1645337-2015-00150
    Event Type
    Injury
    Date Received
    August 10, 2015
    Report Date
    August 10, 2015
    Manufacturer
    M
    Product Code
    FTR
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Occupation
    1

    Narratives

    Description of Event or Problem · 1

    PT'S HUSBAND REPORTED THAT SHE HAS FIBROMYALGIA, ADDED AUTO-IMMUNE LIKE SYMPTOMS. POSSIBLY "DR. (B)(6)" DIAGNOSED FIBROMYALGIA.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    522873 MEMORYSHAPE (SILICONE) SILTEX MEDIUM HEIGHT MEMORY SHAPE PROSTHESES FTR M 267729

    Patients

    Seq Age Sex Outcome Treatment
    1 Other