FDA Adverse Event Injury Summary report: N

UNK MAMMARY IMPLANT

MDR report key: 11631183 · Received April 7, 2021

Report

Report Number
9617229-2021-06051
Event Type
Injury
Date Received
April 7, 2021
Date of Event
January 5, 2021
Report Date
April 7, 2021
Manufacturer
UNKNOWN MANUFACTURER
Product Code
FWM
PMA / PMN Number
P990074
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
NY, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

ARTICLE CITATION: QUESADA, ANDRES E., ZHANG, YANMING, PTASHKIN, RYAN, ET AL. NEXT GENERATION SEQUENCING OF BREAST IMPLANT-ASSOCIATED ANAPLASTIC LARGE CELL LYMPHOMAS REVEALS A NOVEL STAT3-JAK2 FUSION AMONG OTHER ACTIVATING GENETIC ALTERATIONS WITHIN THE JAK-STAT PATHWAY. THE BREAST JOURNAL. 05/JAN/2021; 1-8. THE EVENTS OF LYMPHOMA - ALCL AND SEROMA - LATE ARE PHYSIOLOGICAL COMPLICATIONS AND ANALYSIS OF THE DEVICE GENERALLY DOES NOT ASSIST ALLERGAN IN DETERMINING A PROBABLE CAUSE FOR THESE EVENTS. FURTHER INFORMATION FROM THE REPORTER REGARDING EVENT, PRODUCT, OR PATIENT DETAILS HAS BEEN REQUESTED. NO ADDITIONAL INFORMATION IS AVAILABLE AT THIS TIME. REASON FOR REOPERATION: BIA-ALCL; RIGHT BREAST SWELLING AND EFFUSION EIGHT YEARS AFTER IMPLANT, LYMPHOMA CONTAINED TO FLUID ONLY.

Description of Event or Problem · 1

THROUGH JOURNAL ARTICLE ¿NEXT GENERATION SEQUENCING OF BREAST IMPLANT-ASSOCIATED ANAPLASTIC LARGE CELL LYMPHOMAS REVEALS A NOVEL STAT3-JAK2 FUSION AMONG OTHER ACTIVATING GENETIC ALTERATIONS WITHIN THE JAK-STAT PATHWAY,¿ AUTHORS REPORT ON A (B)(6) YEAR OLD PATIENT AND REASON FOR IMPLANT IS NOTED AS INVASIVE DUCTAL CARCINOMA AND INVASIVE LOBULAR CARCINOMA. PATIENT WAS IMPLANTED WITH A TEXTURED IMPLANT OF AN UNKNOWN FILL AND PRESENTED WITH RIGHT BREAST SWELLING AND EFFUSION EIGHT YEARS AFTER IMPLANT; LYMPHOMA CONTAINED TO FLUID ONLY. THE STAGE OF ALCL WAS NOTED AS T1. TREATMENT PROVIDED AS BILATERAL COMPLETE CAPSULECTOMIES. THE MANUFACTURER OF THE DEVICE IS UNKNOWN. AFFECTED SIDE IS RIGHT. THE STATUS OF THE DEVICE IS UNKNOWN.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
525484 UNK MAMMARY IMPLANT PROSTHESIS, BREAST, INFLATABLE, INTERNAL, SALINE FWM UNKNOWN MANUFACTURER NI

Patients

Seq Age Sex Outcome Treatment
1 61 YR Life Threatening| R