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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: MENTOR TEXAS MENTOR SMOOTH ROUND MODERATE PLUS PROFILE; PROSTHESIS, BREAST, INFLATABLE, INTERNAL, SALINE

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MENTOR TEXAS MENTOR SMOOTH ROUND MODERATE PLUS PROFILE; PROSTHESIS, BREAST, INFLATABLE, INTERNAL, SALINE Back to Search Results
Catalog Number 3502375
Medical Device Problem Code Material Rupture (1546)
Health Effect - Clinical Code Deformity/ Disfigurement (2360)
Date of Event 02/02/2026
Type of Reportable Event Serious Injury
Event or Problem Description
It was reported that a patient underwent a primary breast augmentation surgery with implantation of a 375cc mentor smooth round moderate plus profile saline breast implant prosthesis.Post-operatively, the patient was diagnosed with a deflated right implant during a physical exam.As a result, the patient was scheduled for exchange with a mentor saline implant on (b)(6) 2026.
 
Additional Manufacturer Narrative
Since the device has not been returned for analysis, no product failure analysis can be conducted, and no determination of possible contributing factors can be made.As such, the investigation will be closed.If the complaint device is received in the future, the investigation will be reopened and conducted as appropriate.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.Reason for device explant and/or reoperation: deflation date of explantation: (b)(6) 2026.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).
 
Additional Manufacturer Narrative
On april 07, 2026, the mentor analysis lab received the suspect medical device for evaluation.On april 09, 2026, mentor completed an evaluation on the returned device.Device evaluation: mentor conducted visual inspection, leak testing, and microscopic examination of the device.Visual analysis of the returned device revealed that no damage or anomalies were observed on the breast implant.Leak testing was performed, in accordance with mentor procedures, and a tear was noted on the posterior view measuring approximately 0.1 cm.In addition, no more leak sites were noted after leak testing.Microscopic examination was performed on the edges of the rupture, and parallel striations were found in the whole area of the tear.Parallel striations are consistent with markings made by a sharp object perforating the implant shell.Based on the information currently available, 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.As part of mentor's quality process, all devices are manufactured, inspected, and released according to approved specifications.Based on the results of this investigation, it was determined that the product met the manufacturing release criteria: no corrective and preventive action (capa) is required now.The investigation found the reported event was caused by use error (reasonably foreseeable misuse).Foreseeable misuse is considered in the company¿s risk management documentation.The post-market surveillance (pms) system periodically trends complaint data to detect signals related to product quality, patient safety, and use error.Quality issues that could affect safety are escalated through the quality system and may trigger a trend report when appropriate.Pms reviews and complaints feed into the risk management process; based on current review, no device design, usability, or instructions/training changes are needed.Manufacturer¿s reference number: (b)(4).
 
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Brand Name
MENTOR SMOOTH ROUND MODERATE PLUS PROFILE
Common Device Name
PROSTHESIS, BREAST, INFLATABLE, INTERNAL, SALINE
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
henry boden
3041 skyway circle north
irving, TX 75038
9497882078
MDR Report Key24537371
Report Number1645337-2026-02567
Device Sequence Number18740293
Product Code FWM
UDI-Device Identifier00081317001423
UDI-Public(01)00081317001423(17)290118(10)2036241
Combination Product (Y/N)N
Initial Reporter StateGA
Initial Reporter CountryUS
PMA/510(K) Number
P990075
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2025
Serviced by Third Party (Y/N)Unknown
Reporter Type Manufacturer
Report Source Health Professional
Initial 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
Operator of Device Health Professional
Device Catalogue Number3502375
Device Lot Number2036241
Was Device Available for Evaluation? Device Returned to Manufacturer
Is the Reporter a Health Professional? No
Type of Report(Section G)Initial
Initial Date Received by Manufacturer 02/13/2026
Supplement Date Received by Manufacturer04/07/2026
Initial Report FDA Received Date03/06/2026
Supplement Report FDA Received Date04/10/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured01/22/2025
Is the Device Labeled for Single Use? (Y/N) Yes
Is This a Single-Use Device that was
Reprocessed and Reused on a Patient? (Y/N)
No
Usage of Device Initial
Patient Sequence Number1
Outcome Attributed to Adverse Event Required Intervention;
Patient Age46 YR
Patient SexFemale
Patient EthnicityNon Hispanic
Patient RaceBlack Or African American, White
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