FDA Adverse Event Injury Summary report: N

RESTYLANE

MDR report key: 19332572 · Received May 16, 2024

Report

Report Number
9710154-2024-00029
Event Type
Injury
Date Received
May 16, 2024
Date of Event
March 18, 2024
Report Date
June 12, 2024
Manufacturer
Q-MED
Product Code
LMH
PMA / PMN Number
P040024/S140
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
BR
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

COMPANY COMMENT: THE SERIOUS EVENTS OF OEDEMA AND PAIN AT IMPLANT SITE WERE CONSIDERED EXPECTED AND POSSIBLY RELATED TO THE TREATMENT. SERIOUSNESS CRITERIA INCLUDES THE NEED FOR MEDICAL INTERVENTION AND HOSPITALIZATION TO PREVENT PERMANENT DAMAGE. THE POTENTIAL ROOT CAUSE IS THE TREATMENT PROCEDURE, PATIENT'S HYPERSENSITIVITY TO THE PRODUCT OR USE OF PRODUCT. THE CASE MEETS THE CRITERIA FOR EXPEDITED REPORTING TO THE REGULATORY AUTHORITIES. EVALUATION TEXT: ROUTINE INVESTIGATIONS HAVE BEEN PERFORMED AND PROVIDE SUFFICIENT INFORMATION TO ASSESS THE POTENTIAL ROOT CAUSE. THE REPORTED LOT NUMBER WAS VALID AND VERIFIED THE REPORTED PRODUCT. TO RULE OUT A NON-CONFORMING PRODUCT, A BATCH RECORD REVIEW WILL BE PERFORMED. CAPA COMMENT: NO CORRECTIVE OR PREVENTIVE ACTIONS ARE DEEMED NECESSARY BASED ON THE OUTCOME OF THE CURRENTLY PERFORMED INVESTIGATIONS.

Additional Manufacturer Narrative · 0

COMPANY COMMENT: THE SERIOUS EVENTS OF OEDEMA AND PAIN AT IMPLANT SITE WERE CONSIDERED EXPECTED AND POSSIBLY RELATED TO THE TREATMENT. SERIOUSNESS CRITERIA INCLUDES THE NEED FOR MEDICAL INTERVENTION AND HOSPITALIZATION TO PREVENT PERMANENT DAMAGE. THE POTENTIAL ROOT CAUSE IS THE TREATMENT PROCEDURE OR PATIENT'S HYPERSENSITIVITY TO THE PRODUCT. THE CASE MEETS THE CRITERIA FOR EXPEDITED REPORTING TO THE REGULATORY AUTHORITIES. EVALUATION TEXT: ROUTINE INVESTIGATIONS HAVE BEEN PERFORMED AND PROVIDE SUFFICIENT INFORMATION TO ASSESS THE POTENTIAL ROOT CAUSE. THE REPORTED LOT NUMBER WAS VALID AND VERIFIED THE REPORTED PRODUCT. A BATCH RECORD REVIEW WAS PERFORMED TO RULE OUT A NON-CONFORMING PRODUCT. NO POTENTIAL QUALITY ISSUES WERE IDENTIFIED IN THE MANUFACTURING PROCESS OF THE SPECIFIED BATCH. THE BATCH WAS MANUFACTURED AND RELEASED ACCORDING TO GALDERMA QUALITY MANAGEMENT SYSTEM. THE INFORMATION IN THIS CASE DOES NOT INDICATE A NON-CONFORMING PRODUCT OR MALFUNCTION. THE PERFORMED INVESTIGATIONS ARE THEREFORE CONSIDERED ADEQUATE AND NO ADDITIONAL INVESTIGATIONS WILL BE CONDUCTED. CAPA COMMENT: NO CORRECTIVE OR PREVENTIVE ACTIONS ARE DEEMED NECESSARY BASED ON THE OUTCOME OF THE PERFORMED INVESTIGATIONS.

Description of Event or Problem · 0

CASE REFERENCE NUMBER (B)(4) IS A SPONTANEOUS REPORT SENT ON 03-MAY-2024 BY AN OTHER HEALTH PROFESSIONAL CONCERNING A FEMALE PATIENT OF AN UNKNOWN AGE. ADDITIONAL INFORMATION WAS RECEIVED ON 06-MAY-2024 FROM THE SAME REPORTER. THIS WAS CASE 1 OF 25 (REPORTED BY THE SAME REPORTER). NO INFORMATION ABOUT MEDICAL HISTORY, CONCOMITANT MEDICATION, HISTORY OF ALLERGIES OR PREVIOUS FILLER TREATMENTS HAS BEEN PROVIDED. THE HEALTHCARE PROFESSIONAL HAD PURCHASED 50 RESTYLANE GEL FILLERS IN (B)(6) 2024 AND THE PATIENT WAS TREATED WITH THE RESTYLANE GEL FROM THIS PURCHASE. IN (B)(6) 2024, THE PATIENT RECEIVED TREATMENT WITH RESTYLANE (LOT 21345-1) TO FILL DARK CIRCLES (UNKNOWN AMOUNT, INJECTION TECHNIQUE AND NEEDLE TYPE). ON (B)(6) 2024, THE PATIENT EXPERIENCED SEVERE/EXTREME EDEMA (IMPLANT SITE OEDEMA) IN THE AREA APPLIED. THE PATIENT WAS EVEN HOSPITALIZED WITH A LOT OF PAIN (IMPLANT SITE PAIN) IN THE REGION. THE PATIENT WAS TAKING UNSPECIFIED MEDICATION AS A CORRECTIVE TREATMENT. OUTCOME AT THE TIME OF THE REPORT: EDEMA WAS UNKNOWN. LOT OF PAIN WAS UNKNOWN.

Description of Event or Problem · 0

CASE REFERENCE NUMBER (B)(4) IS A SPONTANEOUS REPORT SENT ON 03-MAY-2024 BY AN OTHER HEALTH PROFESSIONAL CONCERNING A FEMALE PATIENT OF AN UNKNOWN AGE. ADDITIONAL INFORMATION WAS RECEIVED ON 06-MAY-2024 FROM THE SAME REPORTER. THIS WAS CASE 1 OF 25 (REPORTED BY THE SAME REPORTER). NO INFORMATION ABOUT MEDICAL HISTORY, CONCOMITANT MEDICATION, HISTORY OF ALLERGIES OR PREVIOUS FILLER TREATMENTS HAS BEEN PROVIDED. THE HEALTHCARE PROFESSIONAL HAD PURCHASED 50 RESTYLANE GEL FILLERS IN (B)(6) 2024 AND THE PATIENT WAS TREATED WITH THE RESTYLANE GEL FROM THIS PURCHASE. ON AN UNKNOWN DATE IN (B)(6) 2024, THE PATIENT RECEIVED TREATMENT WITH RESTYLANE (LOT 21345-1) TO FILL DARK CIRCLES (UNKNOWN AMOUNT, INJECTION TECHNIQUE AND NEEDLE TYPE). ON (B)(6) 2024, THE PATIENT EXPERIENCED SEVERE/EXTREME EDEMA (IMPLANT SITE OEDEMA) IN THE AREA APPLIED. THE PATIENT WAS EVEN HOSPITALIZED WITH A LOT OF PAIN (IMPLANT SITE PAIN) IN THE REGION. THE PATIENT WAS TAKING UNSPECIFIED MEDICATION AS A CORRECTIVE TREATMENT. OUTCOME AT THE TIME OF THE REPORT: EDEMA WAS UNKNOWN. LOT OF PAIN WAS UNKNOWN. TRACKING LIST: V.0 INITIAL, V.1 BATCH RECORD REVIEW RESULTS WERE RECEIVED ON 17-MAY-2024.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
708170 RESTYLANE IMPLANT, DERMAL, FOR AESTHETIC USE LMH Q-MED 21345-1

Patients

Seq Age Sex Outcome Treatment
1 NA Female Hospitalization| R