FDA Adverse Event
Injury
Summary report: N
SPECTRUM CONTOUR POST-OP ADJUSTABLE
MDR report key: 98517
·
Received June 11, 1997
Report
- Report Number
- 1645337-1997-00074
- Event Type
- Injury
- Date Received
- June 11, 1997
- Report Date
- June 5, 1997
- Manufacturer
- MENTOR H/S, INC.
- Product Code
- LCJ
- Removal / Correction Number
- NA
- Adverse Event
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- MO, US
- Reporter Occupation
- PHYSICIAN
Narratives
Description of Event or Problem · 1
PURSUANT TO INFORMATION RECEIVED FROM THE PHYSICIAN, THE PATIENT WAS BILATERALLY IMPLANTED WITH SILTEX SPECTRUM CONTOUR POST-OP ADJUSTABLE PROSTHESIS ON 02/13/97. SUBSEQUENTLY, IT WAS NOTED THAT THE PATIENT HAD DEVELOPED CHRONIC PAIN AND A SEROMA IN EACH BREAST AND THE PROSTHESIS WERE REMOVED ON 04/11/97. THIS REPORT WAS SUBMITTED TO THE FDA PURSUANT TO NEW "MDR REPORTING GUIDANCE FOR BREAST IMPLANTS" (MENTOR EFFECTIVE DATE, FEBRUARY 10, 1992). ANY PERCEIVED INCREASE IN FREQUENCY OF EVENTS IS RELATED TO THE FILING OF REPORTS FOR EVENTS, WHICH WERE PREVIOUSLY NOT MDR REPORTABLE EVENTS PER 21CFR803.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1 | SPECTRUM CONTOUR POST-OP ADJUSTABLE Implant | EXPANDER/MAMMARY PROSTH | LCJ | MENTOR H/S, INC. | NA | 150935/150935 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 52 YR | Required Intervention |