FDA Adverse Event Injury Summary report: N

INSPIRA TEXTURED SILICONE GEL FILLED BREAST IMPLANT

MDR report key: 19920362 · Received August 6, 2024

Report

Report Number
9617229-2024-18268
Event Type
Injury
Date Received
August 6, 2024
Report Date
December 28, 2024
Manufacturer
ALLERGAN (COSTA RICA)
Product Code
FTR
PMA / PMN Number
P020056
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
VA, US
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

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. 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.

Additional Manufacturer Narrative · 0

A REVIEW OF THE DEVICE HISTORY RECORD HAS BEEN COMPLETED. NO DEVIATIONS OR NON-CONFORMANCES NOTED.

Description of Event or Problem · 0

HEALTHCARE PROFESSIONAL REPORTED LEFT SIDE "RUPTURED AND TEXTURED" DEVICE. DEVICE HAS BEEN EXPLANTED AND REPLACED.

Description of Event or Problem · 0

HEALTHCARE PROFESSIONAL REPORTED LEFT SIDE "RUPTURED AND TEXTURED" DEVICE. DEVICE HAS BEEN EXPLANTED AND REPLACED.

Description of Event or Problem · 0

UPON FURTHER REVIEW, THIS RECORD IS A DUPLICATE OF CN-083313 IN REGARD TO SN (B)(6). ALL RELEVANT INFORMATION FROM THIS RECORD WILL BE TRANSFERRED TO CN-083313 AND THIS RECORD WILL BE UN-REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1572896 INSPIRA TEXTURED SILICONE GEL FILLED BREAST IMPLANT PROSTHESIS, BREAST, NONINFLATABLE, INTERNAL, SILICONE GEL-FILLED FTR ALLERGAN (COSTA RICA) 2868678

Patients

Seq Age Sex Outcome Treatment
1 NA Female Required Intervention