FDA Adverse Event Injury Summary report: N

INSPIRA TEXTURED SILICONE GEL FILLED BREAST IMPLANT

MDR report key: 19277440 · Received May 9, 2024

Report

Report Number
9617229-2024-07994
Event Type
Injury
Date Received
May 9, 2024
Report Date
April 15, 2025
Manufacturer
ALLERGAN (COSTA RICA)
Product Code
FTR
PMA / PMN Number
P020056
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
BR
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

CONTINUED: A.4. WEIGHT: 62.3 KG E.1. PHONE NUMBER: +(B)(6). A REVIEW OF THE DEVICE HISTORY RECORD HAS BEEN INITIATED. IF ANY NEW, CHANGED OR CORRECTED INFORMATION IS NOTED, A SUPPLEMENTAL MEDWATCH WILL BE SUBMITTED. THE EVENT OF "SEROMA-LATE" 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: SEROMA-LATE AND RUPTURE.

Additional Manufacturer Narrative · 0

CORRECTION TO G.3. AWARE DATE OF SUPPLEMENTAL MEDWATCH #1. AWARE DATE SHOULD HAVE BEEN LISTED AS 29/MAY/2024.

Additional Manufacturer Narrative · 0

ADDITIONAL, CHANGED, AND/OR CORRECTED DATA: B.5, D.6B, H.6.

Description of Event or Problem · 0

HEALTHCARE PROFESSIONAL REPORTED RIGHT SIDE "RADIAL FOLDS", "CYSTS", "COLLECTION [OF FLUID]", AND "RUPTURE." THE DEVICE REMAINS IMPLANTED.

Description of Event or Problem · 0

HEALTHCARE PROFESSIONAL REPORTED RIGHT SIDE "RADIAL FOLDS", "CYSTS", "COLLECTION [OF FLUID]", AND "RUPTURE." THE DEVICE HAS BEEN EXPLANTED.

Description of Event or Problem · 0

THE DEVICE HAS BEEN EXPLANTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1478175 INSPIRA TEXTURED SILICONE GEL FILLED BREAST IMPLANT PROSTHESIS, BREAST, NONINFLATABLE, INTERNAL, SILICONE GEL-FILLED FTR ALLERGAN (COSTA RICA) 2833726

Patients

Seq Age Sex Outcome Treatment
1 NA Female Required Intervention