FDA Adverse Event Injury Summary report: N

INSPIRA TEXTURED SILICONE GEL FILLED BREAST IMPLANT

MDR report key: 18843155 · Received March 5, 2024

Report

Report Number
9617229-2024-03788
Event Type
Injury
Date Received
March 5, 2024
Date of Event
January 1, 2021
Report Date
March 28, 2025
Manufacturer
ALLERGAN (COSTA RICA)
Product Code
FTR
PMA / PMN Number
P020056
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
BR
Reporter Occupation
OTHER
Health Professional
N

Narratives

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. 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: CAPSULAR CONTRACTURE, BAKER GRADE III/IV.

Additional Manufacturer Narrative · 0

ADDITIONAL, CHANGED, AND/OR CORRECTED DATA: B.5, B.6, H.6. THE EVENT OF SEROMA IS A PHYSIOLOGICAL COMPLICATION AND ANALYSIS OF THE DEVICE GENERALLY DOES NOT ASSIST ALLERGAN IN DETERMINING A PROBABLE CAUSE FOR THIS EVENT.

Additional Manufacturer Narrative · 0

CORRECTION TO G.3. AWARE DATE OF SUPPLEMENTAL MEDWATCH #1. AWARE DATE SHOULD HAVE BEEN LISTED AS 02/JUL/2024.

Additional Manufacturer Narrative · 0

A REVIEW OF THE DEVICE HISTORY RECORD HAS BEEN COMPLETED. NO DEVIATIONS OR NON-CONFORMANCES NOTED. DEVICE PHOTO EVALUATION: VISUAL ANALYSIS OF THE PHOTOGRAPHS IDENTIFIED: ¿ WRINKLING OF THE SKIN: UNABLE TO OBSERVE SINCE IT IS NOT RELATED TO THE DEVICE. ¿ SEROMA: UNABLE TO OBSERVE SINCE IT IS NOT RELATED TO THE DEVICE. ¿ DEVICE WRINKLING: UNABLE TO OBSERVE SINCE IT IS NOT RELATED TO THE DEVICE. ¿ CYST: UNABLE TO OBSERVE SINCE IT IS NOT RELATED TO THE DEVICE. ¿ CREASE / FOLDING OF IMPLANT: NOT OBSERVED ¿ CAPSULAR CONTRACTURE: UNABLE TO OBSERVE SINCE IT IS NOT RELATED TO THE DEVICE. ¿ ANXIETY - PRODUCT/ PROCEDURE: UNABLE TO OBSERVE SINCE IT IS NOT RELATED TO THE DEVICE. NO FURTHER ACTIONS ARE REQUIRED SINCE NO ISSUE IN THE MANUFACTURING OF THE DEVICE IS OBSERVED. THE EVENT OF SEROMA IS A PHYSIOLOGICAL COMPLICATION AND ANALYSIS OF THE DEVICE GENERALLY DOES NOT ASSIST ALLERGAN IN DETERMINING A PROBABLE CAUSE FOR THIS EVENT.

Description of Event or Problem · 0

PATIENT REPORTED LEFT SIDE PAIN, UPTURNED PROSTHESIS, GRADE III OR IV CAPSULAR CONTRACTURE AND "RECALL." THE DEVICE REMAINS IMPLANTED.

Description of Event or Problem · 0

PATIENT REPORTED LEFT SIDE PAIN, UPTURNED PROSTHESIS, GRADE III OR IV CAPSULAR CONTRACTURE AND "RECALL." THE DEVICE REMAINS IMPLANTED.

Description of Event or Problem · 0

PATIENT REPORTED PAIN, HARDENED BREASTS, TWO FINGERS GAVE WAY, CAPSULAR CONTRACTURE III OR IV." HEALTHCARE PROFESSIONAL LATER REPORTED THICKENING AND ENHANCEMENT OF THE FIBROUS CAPSULE, RADIAL FOLDS, FLUID ADJACENT TO THE IMPLANT, BREAST DEFORMITY, AND RIPPLING. HEALTHCARE PROFESSIONAL LATER REPORTED SIMPLE CYST MEASURING 0.3 CM IN THE 'QSM' OF THE LEFT BREAST NOT RELATED TO THE DEVICE. THE DEVICE HAS BEEN EXPLANTED.

Description of Event or Problem · 0

PATIENT REPORTED PAIN, HARDENED BREASTS, TWO FINGERS GAVE WAY, CAPSULAR CONTRACTURE III OR IV." HEALTHCARE PROFESSIONAL LATER REPORTED THICKENING AND ENHANCEMENT OF THE FIBROUS CAPSULE, RADIAL FOLDS, FLUID ADJACENT TO THE IMPLANT, BREAST DEFORMITY, AND RIPPLING. HEALTHCARE PROFESSIONAL LATER REPORTED SIMPLE CYST MEASURING 0.3 CM IN THE 'QSM' OF THE LEFT BREAST NOT RELATED TO THE DEVICE. THE DEVICE HAS BEEN EXPLANTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1670061 INSPIRA TEXTURED SILICONE GEL FILLED BREAST IMPLANT PROSTHESIS, BREAST, NONINFLATABLE, INTERNAL, SILICONE GEL-FILLED FTR ALLERGAN (COSTA RICA) 2794316
354160 INSPIRA TEXTURED SILICONE GEL FILLED BREAST IMPLANT PROSTHESIS, BREAST, NONINFLATABLE, INTERNAL, SILICONE GEL-FILLED FTR ALLERGAN (COSTA RICA) 2794316

Patients

Seq Age Sex Outcome Treatment
1 24 YR Female Required Intervention