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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: MENTOR TEXAS MENTOR MEMORYGEL BREAST IMPLANT; PROSTHESIS, BREAST, NONINFLATABLE, INTERNAL, SILICONE GEL-FILLED

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MENTOR TEXAS MENTOR MEMORYGEL BREAST IMPLANT; PROSTHESIS, BREAST, NONINFLATABLE, INTERNAL, SILICONE GEL-FILLED Back to Search Results
Catalog Number 3504004BC
Device Problems Material Rupture (1546); Appropriate Term/Code Not Available (3191)
Patient Problem Capsular Contracture (1761)
Event Date 02/26/2024
Event Type  Injury  
Manufacturer Narrative
The mentor failure analysis lab has received the device for evaluation.The analysis has begun but is not complete at this time.When the investigational analysis has been completed, a supplemental report will be submitted.A manufacturing record evaluation (mre) was performed, and no anomalies were found related to this complaint.In addition, the mre verifies that the device was manufactured in accordance with documented specification and procedures.Mentor is submitting this report pursuant to the provisions of 21 cfr, part 803.This report may be based on information which mentor has not been able to investigate or verify prior to the required reporting date.This report does not reflect a conclusion by fda, mentor, or its employees that the report constitutes an admission that the device, mentor, or its employees caused or contributed to the potential event described in this report.If certain information is unknown, not available or does not apply, the section/field of the form is left blank.Manufacturer¿s reference number: (b)(4).
 
Event Description
It was reported that a patient implanted with two mentor memorygel breast implant experienced bilateral ruptures and bubbles, a reaction on the left side and capsular contracture (baker grade 2-3) on the right side post-operatively.As a result, the patient underwent explantation on (b)(6) 2024.This report is for the right side device.
 
Manufacturer Narrative
Device evaluation summary: the product was returned to mentor for evaluation.Mentor then conducted a visual inspection, leak testing, and microscopic examination of the returned device.Visual analysis of the returned sample revealed that the smooth hpg, 400cc breast implant was found to have some bubbles within the gel.Leak testing was performed, according to the mentor procedure, and it revealed (4) four punctures on the posterior view, all of them measuring approximately 0.1 cm.The bubbles reported by the customer could have appeared due to the punctures.Microscopic examination was performed on the edges of the punctures, and parallel striations were found in the whole area of the punctures.Parallel striations are consistent with markings made by a sharp object perforating the implant shell.Based on the information currently available, a microscopic examination of the returned product indicates that the implant could have been damaged during or subsequent to implantation.The product insert data sheet cautions to not allow cautery devices or sharp instruments, such as scalpels, suture needles, hypodermic needles, hemostats, adson forceps, or scissors to contact the device during the implantation or other surgical procedures.Mentor concluded that the capsular contracture in the patient´s breast was the result of the body´s individual physiological response to the implantation of a foreign object in soft tissue.Capsular contracture is a known complication associated with these devices and is referenced in our current product insert data sheet.The american society of plastic surgeons recommends and encourages member surgeons to always submit breast implants, capsule, and effusion to pathology for examination.As part of mentor¿s quality process, all devices are manufactured, inspected, and released to approved specifications.No corrective and preventive action (capa) is required now.Additional complaint information monitoring for potential safety signals is conducted through complaint trending as part of post-market surveillance.Manufacturer¿s reference number: (b)(4).
 
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Brand Name
MENTOR MEMORYGEL BREAST IMPLANT
Type of Device
PROSTHESIS, BREAST, NONINFLATABLE, INTERNAL, SILICONE GEL-FILLED
Manufacturer (Section D)
MENTOR TEXAS
3041 skyway circle north
irving TX 75038
Manufacturer (Section G)
MENTOR TEXAS
3041 skyway circle north
irving TX 75038
Manufacturer Contact
kate karberg
3041 skyway circle north
irving, TX 75038
3035526892
MDR Report Key19116914
MDR Text Key340286954
Report Number1645337-2024-04542
Device Sequence Number1
Product Code FTR
UDI-Device Identifier00081317000501
UDI-Public00081317000501
Combination Product (y/n)N
Reporter Country CodeUS
PMA/PMN Number
P030053
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Health Professional
Reporter Occupation Other
Type of Report Initial,Followup
1 Device was Involved in the Event
1 Patient was Involved in the Event
Is this an Adverse Event Report? Yes
Is this a Product Problem Report? Yes
Device Operator Health Professional
Device Catalogue Number3504004BC
Device Lot Number9916440
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer04/15/2024
Is the Reporter a Health Professional? No
Initial Date Manufacturer Received 03/22/2024
Initial Date FDA Received04/16/2024
Supplement Dates Manufacturer Received04/22/2024
Supplement Dates FDA Received04/29/2024
Was Device Evaluated by Manufacturer? Yes
Date Device Manufactured05/26/2023
Is the Device Single Use? Yes
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Initial
Removal/Correction NumberN/A
Patient Sequence Number1
Patient Outcome(s) Required Intervention;
Patient Age49 YR
Patient SexFemale
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