FDA Adverse Event Injury Summary report: N

INSPIRA TEXTURED SILICONE GEL FILLED BREAST IMPLANT

MDR report key: 18065171 · Received November 3, 2023

Report

Report Number
9617229-2023-18635
Event Type
Injury
Date Received
November 3, 2023
Date of Event
January 5, 2017
Report Date
March 22, 2024
Manufacturer
ALLERGAN (COSTA RICA)
Product Code
FTR
UDI-DI
05060191606707
PMA / PMN Number
P020056
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
SP
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

DEVICE EVALUATION: BASED ON THE DEVICE ANALYSIS GRID, THE ASSESSMENTS OF THE COMPLAINT ARE: RUPTURE : OBSERVED, OPENING ASSESSED AS FOLD FLAW OPENING. ADDITIONAL OBSERVATIONS: NO PENETRATING NICK (STRESS MARKS). NO FURTHER ACTIONS ARE REQUIRED AS NO ISSUES WITH THE MANUFACTURING PROCESS ARE OBSERVED.

Additional Manufacturer Narrative · 0

THE EVENT OF "LYMPH NODES OF REACTIVE ASPECT" IS A PHYSIOLOGICAL COMPLICATION AND ANALYSIS OF THE DEVICE GENERALLY DOES NOT ASSIST ALLERGAN IN DETERMINING A PROBABLE CAUSE FOR THIS EVENT. 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: RUPTURE & LYMPHADENOPATHY.

Additional Manufacturer Narrative · 0

VISUAL ANALYSIS OF THE PHOTOGRAPHS IDENTIFIED: CAPSULAR CONTRACTURE: UNABLE TO OBSERVE SINCE IT IS NOT RELATED TO THE DEVICE. RUPTURE: OBSERVED BUT CANNOT PERFORM AN ASSESSMENT OF THE OPENING AS NO MICROSCOPIC ANALYSIS CAN BE PERFORMED. LYMPHADENOPATHY: UNABLE TO OBSERVE SINCE IT IS NOT RELATED TO THE DEVICE. NO ADDITIONAL OBSERVATIONS ARE PERFORMED. NO FURTHER ACTIONS ARE REQUIRED AS NO MANUFACTURING ISSUES ARE OBSERVED.

Additional Manufacturer Narrative · 0

THE EVENT OF CAPSULAR CONTRACTURE IS A PHYSIOLOGICAL COMPLICATION AND ANALYSIS OF THE DEVICE GENERALLY DOES NOT ASSIST ALLERGAN IN DETERMINING A PROBABLE CAUSE FOR THIS EVENT. A REVIEW OF THE DEVICE HISTORY RECORD HAS BEEN COMPLETED. NO DEVIATIONS OR NON-CONFORMANCES NOTED.

Description of Event or Problem · 0

A HEALTHCARE PROFESSIONAL REPORTED LEFT PROSTHESIS WITH SIGNS OF INTRACAPSULAR RUPTURE, LYMPH NODES OF REACTIVE ASPECT IN LEFT ARMPIT. BI-RADS 2. IT WAS LATER CONFIRMED BY THE HCP CAPSULAR CONTRACTURE BAKER GRADE IV. THE DEVICE HAS BEEN EXPLANTED AND REPLACED WITH A NON ALLERGAN DEVICE.

Description of Event or Problem · 0

A HEALTHCARE PROFESSIONAL REPORTED LEFT PROSTHESIS WITH SIGNS OF INTRACAPSULAR RUPTURE, LYMPH NODES OF REACTIVE ASPECT IN LEFT ARMPIT. BI-RADS 2. THE DEVICE REMAINS IMPLANTED.

Description of Event or Problem · 0

A HEALTHCARE PROFESSIONAL REPORTED LEFT PROSTHESIS WITH SIGNS OF INTRACAPSULAR RUPTURE, LYMPH NODES OF REACTIVE ASPECT IN LEFT ARMPIT. BI-RADS 2. IT WAS LATER CONFIRMED BY THE HCP CAPSULAR CONTRACTURE BAKER GRADE IV. THE DEVICE HAS BEEN EXPLANTED AND REPLACED WITH A NON ALLERGAN DEVICE.

Description of Event or Problem · 0

IT WAS LATER CONFIRMED BY THE HEALTHCARE PROFESSIONAL CAPSULAR CONTRACTURE BAKER GRADE IV. THE DEVICE HAS BEEN EXPLANTED AND REPLACED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2207822 INSPIRA TEXTURED SILICONE GEL FILLED BREAST IMPLANT PROSTHESIS, BREAST, NONINFLATABLE, INTERNAL, SILICONE GEL-FILLED FTR ALLERGAN (COSTA RICA) 1402558 05060191606707
266357 INSPIRA TEXTURED SILICONE GEL FILLED BREAST IMPLANT PROSTHESIS, BREAST, NONINFLATABLE, INTERNAL, SILICONE GEL-FILLED FTR ALLERGAN (COSTA RICA) 1402558 05060191606707

Patients

Seq Age Sex Outcome Treatment
1 50 YR Female Required Intervention