FDA Adverse Event Injury Summary report: N

UNK MAMMARY IMPLANT

MDR report key: 15014752 · Received July 14, 2022

Report

Report Number
9617229-2022-11524
Event Type
Injury
Date Received
July 14, 2022
Date of Event
January 1, 2015
Report Date
September 1, 2022
Manufacturer
ALLERGAN (COSTA RICA)
Product Code
FWM
PMA / PMN Number
P990074
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
SF
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

"A SOUTH AFRICAN BREAST IMPLANT-ASSOCIATED ANAPLASTIC LARGE CELL LYMPHOMA: CLINICAL PRESENTATION AND SIX-YEAR FOLLOW-UP". ALEXANDRA GRUBNIK, YASTIRA RAMDAS, BAREND VAN DER BERGH, SIMON NAYLER, CAROL-ANN BENN AND BERNARDO L. RAPOPORT. HINDAWI, CASE REPORTS IN ONCOLOGICAL MEDICINE, VOLUME 2022, HTTPS://DOI.ORG/10.1155/2022/4162832 31MAY22. (B)(4). THE EVENTS OF LYMPHOMA-ALCL, SEROMA-LATE, LUMP/NODULE, LYMPHADENOPATHY 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: LYMPHOMA-ALCL, SEROMA-LATE, LUMP/NODULE, LYMPHADENOPATHY.

Additional Manufacturer Narrative · 0

ADDITIONAL, CHANGED, AND/OR CORRECTED DATA: B.3.

Description of Event or Problem · 0

HEALTHCARE PROFESSIONAL REPORTED VIA LITERATURE ARTICLE "A SOUTH AFRICAN BREAST IMPLANT-ASSOCIATED ANAPLASTIC LARGE CELL LYMPHOMA: CLINICAL PRESENTATION AND SIX-YEAR FOLLOW-UP": PATIENT PRESENTED WITH INITIAL SWELLING OF THE LEFT BREAST. MAMMOGRAPHY, ULTRASOUND, AND MRI REVEALED A PERIPROSTHETIC FLUID COLLECTION AND MASS-LIKE ENHANCEMENT ON THE LEFT BREAST SHOWING SUSTAINED PERIPHERAL ENHANCEMENT. BIOMARKERS CD30+ AND ALK- WERE RECEIVED, INDICATIVE OF BIA-ALCL. THE PATIENT UNDERWENT ¿EN BLOC¿ CAPSULECTOMY. SURGERY AND RECOVERY WERE UNEVENTFUL. THE CAPSULECTOMY REVEALED FIBROUS CONNECTIVE TISSUE WITH THE TUMOR BIOPSY SHOWING EXTENSIVE AREAS OF BROAD COAGULATIVE NECROSIS WITH FOAMY HISTIOCYTES. PATIENT ALSO HAD A REACTIVE AXILLARY LYMPH NODE WITHOUT LYMPHOMA INVOLVEMENT. FOLLOWING SURGERY, THE PATIENT NOTED REDUCED SWELLING AND PAIN. A SIX-WEEK FOLLOW-UP EXAMINATION REVEALED NO INFLAMMATION, REDUCED PAIN LEVELS, AND NO EVIDENCE OF RECURRENCE. NO AXILLARY OR SUPRACLAVICULAR PATHOLOGICAL LYMPHADENOPATHY WAS SEEN. THE PATIENT WAS FOLLOWED UP AT A SIX-MONTH INTERVAL FOR FIVE YEARS. CURRENTLY, THE PATIENT IS FOLLOWED UP YEARLY, AND REMAINS IN REMISSION AT YEAR SIX.

Description of Event or Problem · 0

HEALTHCARE PROFESSIONAL REPORTED VIA LITERATURE ARTICLE "A SOUTH AFRICAN BREAST IMPLANT-ASSOCIATED ANAPLASTIC LARGE CELL LYMPHOMA: CLINICAL PRESENTATION AND SIX-YEAR FOLLOW-UP": PATIENT PRESENTED WITH INITIAL SWELLING OF THE LEFT BREAST. MAMMOGRAPHY, ULTRASOUND, AND MRI REVEALED A PERIPROSTHETIC FLUID COLLECTION AND MASS-LIKE ENHANCEMENT ON THE LEFT BREAST SHOWING SUSTAINED PERIPHERAL ENHANCEMENT. BIOMARKERS CD30+ AND ALK- WERE RECEIVED, INDICATIVE OF BIA-ALCL. THE PATIENT UNDERWENT ¿EN BLOC¿ CAPSULECTOMY. SURGERY AND RECOVERY WERE UNEVENTFUL. THE CAPSULECTOMY REVEALED FIBROUS CONNECTIVE TISSUE WITH THE TUMOR BIOPSY SHOWING EXTENSIVE AREAS OF BROAD COAGULATIVE NECROSIS WITH FOAMY HISTIOCYTES. PATIENT ALSO HAD A REACTIVE AXILLARY LYMPH NODE WITHOUT LYMPHOMA INVOLVEMENT. FOLLOWING SURGERY, THE PATIENT NOTED REDUCED SWELLING AND PAIN. A SIX-WEEK FOLLOW-UP EXAMINATION REVEALED NO INFLAMMATION, REDUCED PAIN LEVELS, AND NO EVIDENCE OF RECURRENCE. NO AXILLARY OR SUPRACLAVICULAR PATHOLOGICAL LYMPHADENOPATHY WAS SEEN. THE PATIENT WAS FOLLOWED UP AT A SIX-MONTH INTERVAL FOR FIVE YEARS. CURRENTLY, THE PATIENT IS FOLLOWED UP YEARLY, AND REMAINS IN REMISSION AT YEAR SIX.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2061037 UNK MAMMARY IMPLANT PROSTHESIS, BREAST, INFLATABLE, INTERNAL, SALINE FWM ALLERGAN (COSTA RICA) NI

Patients

Seq Age Sex Outcome Treatment
1 61 YR Female Life Threatening