FDA Adverse Event Injury Summary report: N

RHA2

MDR report key: 11517564 · Received March 18, 2021

Report

Report Number
3007772056-2021-00003
Event Type
Injury
Date Received
March 18, 2021
Date of Event
February 17, 2021
Report Date
February 24, 2021
Manufacturer
TEOXANE
Product Code
LMH
Adverse Event
Yes
Product Problem
Yes
Report Source
Distributor report
Reporter Location
FL, US
Reporter Occupation
117

Narratives

Description of Event or Problem · 1

HERPETIC INFECTION [ORAL HERPES], BRUISE AND LOOKED DARK AND DUSTY; VASCULAR OCCLUSION/COMPRESSION IN A SMALL BRANCH OF THE SUPERIOR LABIAL ARTERY [VASCULAR OCCLUSION], PLUNGER PULLER OUT UPON ASPIRATION [DEVICE CONNECTION ISSUE], INJECTED IN RIGHT UPPER LIP [OFF LABEL USE]. UNITED STATES REPORT FROM A NURSE ON (B)(6) 2021. A NURSE REPORTED THAT A (B)(6) FEMALE RECEIVED RHA2 ON (B)(6) 2021 WITH UNKNOWN DOSE AND FREQUENCY. THE PATIENT WAS INJECTED WITH 1 SYRINGE OF RHA2 IN THE RIGHT UPPER LIP. THE TECHNIQUE USED FOR ADMINISTRATION OF RHA2 WAS UNKNOWN. IT WAS NOT REPORTED WHETHER A CANNULA WAS USED FOR ADMINISTRATION. PREVIOUS COSMETIC PROCEDURES OF JUVADERM WAS LAST INJECTED APPROXIMATELY 1 ½ YRS AGO. MEDICAL HISTORY INCLUDED HERPES INFECTION AND CONCOMITANT MEDICATIONS AND FOOD SUPPLEMENTS WERE NOT PROVIDED. ON (B)(6) 2021, 24 HOURS POST INJECTION, THE PATIENT DEVELOPED SYMPTOMS OF "SIGNIFICANT" HERPETIC INFECTION WITH PAIN AND LIPS BEGAN BRUISE AND LOOK DARK AND DUSTY, AND NO SWELLING. THE PATIENT EXPERIENCED A VASCULAR OCCLUSION/COMPRESSION IN A SMALL BRANCH OF THE SUPERIOR LABIAL ARTERY. THE PATIENT DID NOT HAVE ANY PAIN FROM THE OCCLUSION. TREATMENT INCLUDED VALTREX, ASPIRIN, AND A WARM COMPRESS. TWO DAYS LATER, THE AREA HAD NOT LIGHTENED UP AND STILL LOOKED MOTTLED. THEN IT WAS DECIDED TO DISSOLVE THE FILLER WITH 200UNITS OF VITRASE AND SALINE TO THE RIGHT UPPER LIP. AFTER DISSOLVING THE FILLER, THE AREA IMPROVED SIGNIFICANTLY AND NOW THE PATIENT HAD A FAINT "PURPLE HUE." THE OUTCOME OF THE EVENTS WAS RECOVERING. IT WAS UNKNOWN IF THE PRODUCT WAS AVAILABLE FOR RETURN. (B)(4) NO ADDITIONAL INFORMATION WAS AVAILABLE AT THE TIME OF THIS REPORT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
408407 RHA2 RESILIENT HYALURONIC ACID LMH TEOXANE G10 (01) 07640173230014

Patients

Seq Age Sex Outcome Treatment
1 50 YR Other