FDA Adverse Event Injury Summary report: N

INSPIRA TEXTURED SILICONE GEL FILLED BREAST IMPLANT

MDR report key: 19477580 · Received June 6, 2024

Report

Report Number
9617229-2024-09630
Event Type
Injury
Date Received
June 6, 2024
Report Date
December 5, 2024
Manufacturer
ALLERGAN (COSTA RICA)
Product Code
FTR
UDI-DI
05060191606394
PMA / PMN Number
P020056
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
UK
Reporter Occupation
003

Narratives

Additional Manufacturer Narrative · 0

THE EVENT OF LYMPHOMA 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: LYMPHOMA-ALCL-SUSPECTED.

Additional Manufacturer Narrative · 0

SINCE THE AFFECTED SIDE IS NOT SPECIFIED. PROVIDING DEVICE INFORMATION FOR BOTH SIDES: LEFT: INSPIRA TRX. REF: N-TRX400. LOT: 2791442. SN: (B)(6). RIGHT: INSPIRA TRX. REF: N-TRX400. LOT: 2871964. SN: (B)(6). ADDITIONAL, CHANGED, AND/OR CORRECTED DATA: B2, H6.

Additional Manufacturer Narrative · 0

A REVIEW OF THE DEVICE HISTORY RECORD HAS BEEN COMPLETED. NO DEVIATIONS OR NON-CONFORMANCES NOTED. CLARIFICATION TO FURTHER INVESTIGATION AND DEVICE INFORMATION: DEVICE DETAILS FOR BOTH SIDES WERE PROVIDED, BUT AFFECTED SIDE IS UNKNOWN. FI SUMMARY (LEFT INSPIRA TRX, REF: (B)(4), LOT: 2791442, SN: (B)(6) , D4 EXPIRY DATE: 8/24/2020, H4 MANUF. DATE: 8/24/2015) THE REVIEW OF THE DOCUMENTATION ASSOCIATED TO THE MANUFACTURING PROCESS INDICATES THAT ALL DEVICES WITH LOT NUMBER 2791442 WERE RELEASED IN ACCORDANCE WITH ABBVIE¿S PROCEDURES AND WERE NO DEFECTS/PROBLEMS/ISSUES FOUND IN THE DOCUMENTS OR IN THE PERSONNEL TRAINING RELATED TO THE REPORTED EVENT. ADDITIONALLY, NO ER/ NCR(S) WERE IDENTIFIED DURING THE INVESTIGATION ASSOCIATED WITH THIS LOT AND THE COMPLAINT. ACCORDING TO THE COMPLAINT REVIEW THERE IS NO INFORMATION IF THE DEVICE WILL BE RETURNED FOR ANALYSIS IN THE DEVICE ANALYSIS LABORATORY, HOWEVER THE REPORTED MEDICAL EVENTS ARE UNABLE TO OBSERVE, THEREFORE THEY ARE NOT CONFIRMED. A REVIEW OF THE CURRENT RISK DOCUMENTS WAS PERFORMED IN RMF-CHL-BI FAMILY (V15.0), AND THE EVENT OF BIA-ALCL IS A KNOWN HAZARD FOR BREAST IMPLANTS. CONSIDERING THAT THERE IS NO ADVERSE TREND FOR THIS TYPE OF EVENT, NO ADDITIONAL ACTIONS ARE DEEMED REQUIRED AT THIS TIME. THE ISSUE WITH LYMPHOMA ALCL SUSPECTED WILL CONTINUE TO BE MONITORED AND CORRECTIVE ACTIONS WILL BE TAKEN IN THE FUTURE IF DEEMED APPROPRIATE. FI SUMMARY (RIGHT INSPIRA TRX, REF: (B)(4), LOT: 2871964, SN: (B)(6), D4 EXPIRY DATE: 2/20/2021, H4 MANUF. DATE: 2/20/2016). THE REVIEW OF THE DOCUMENTATION ASSOCIATED TO THE MANUFACTURING PROCESS INDICATES THAT ALL DEVICES WITH LOT NUMBER 2871964 WERE RELEASED IN ACCORDANCE WITH ABBVIE¿S PROCEDURES AND WERE NO DEFECTS/PROBLEMS/ISSUES FOUND IN THE DOCUMENTS OR IN THE PERSONNEL TRAINING RELATED TO THE REPORTED EVENT. ADDITIONALLY, NO ER/ NCR(S) WERE IDENTIFIED DURING THE INVESTIGATION ASSOCIATED WITH THIS LOT AND THE COMPLAINT. ACCORDING TO THE COMPLAINT REVIEW THERE IS NO INFORMATION IF THE DEVICE WILL BE RETURNED FOR ANALYSIS IN THE DEVICE ANALYSIS LABORATORY, HOWEVER THE REPORTED EVENT IS CLASSIFIED AS MEDICAL, AND THESE EVENTS ARE UNABLE TO CONFIRM. A REVIEW OF THE CURRENT RISK DOCUMENTS WAS PERFORMED IN RMF-CHL-BI FAMILY (V15.0), AND THE EVENT OF BIA-ALCL IS A KNOWN HAZARD FOR BREAST IMPLANTS. CONSIDERING THAT THERE IS NO ADVERSE TREND FOR THIS TYPE OF EVENT, NO ADDITIONAL ACTIONS ARE DEEMED REQUIRED AT THIS TIME. THE ISSUE WITH LYMPHOMA ALCL SUSPECTED WILL CONTINUE TO BE MONITORED AND CORRECTIVE ACTIONS WILL BE TAKEN IN THE FUTURE IF DEEMED APPROPRIATE.

Description of Event or Problem · 0

PATIENT REPRESENTATIVE REPORTED UNKNOWN SIDE 'CONFIRMED DIAGNOSIS OF BIA-ALCL.' PATHOLOGICAL MARKERS HAVE NOT BEEN PROVIDED. DEVICE REMAINS IMPLANTED.

Description of Event or Problem · 0

PATIENT REPRESENTATIVE REPORTED UNKNOWN SIDE 'CONFIRMED DIAGNOSIS OF BIA-ALCL.' PATHOLOGICAL MARKERS HAVE NOT BEEN PROVIDED. DEVICE REMAINS IMPLANTED.

Description of Event or Problem · 0

PATIENT REPRESENTATIVE REPORTED UNKNOWN SIDE 'CONFIRMED DIAGNOSIS OF BIA-ALCL' WHICH WILL BE REPORTED AS LYMPHOMA-ALCL-SUSPECTED. PATHOLOGICAL MARKERS HAVE NOT BEEN PROVIDED. DEVICE REMAINS IMPLANTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2054589 INSPIRA TEXTURED SILICONE GEL FILLED BREAST IMPLANT PROSTHESIS, BREAST, NONINFLATABLE, INTERNAL, SILICONE GEL-FILLED FTR ALLERGAN (COSTA RICA) NI 05060191606394

Patients

Seq Age Sex Outcome Treatment
1 NA Female Life Threatening| R