FDA Adverse Event Injury Summary report: N

INSPIRA TEXTURED SILICONE GEL FILLED BREAST IMPLANT

MDR report key: 21305319 · Received February 4, 2025

Report

Report Number
9617229-2025-01896
Event Type
Injury
Date Received
February 4, 2025
Date of Event
February 14, 2017
Report Date
February 5, 2025
Manufacturer
ALLERGAN (COSTA RICA)
Product Code
FTR
PMA / PMN Number
P020056
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
AS
Reporter Occupation
003

Narratives

Additional Manufacturer Narrative · 0

ADDITIONAL, CHANGED, AND/OR CORRECTED DATA: B5, H10 THIS REPORT HAS BEEN CONFIRMED AS A DUPLICATE OF MRN 9617229-2025-0000026 AND WAS INITIALLY REPORTED IN ERROR. SEE RELATED MRN FOR ALL RELEVANT INFORMATION.

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. 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. FURTHER INFORMATION FROM THE REPORTER REGARDING EVENT, PRODUCT, OR PATIENT DETAILS HAS BEEN/WILL BE REQUESTED. NO ADDITIONAL INFORMATION IS AVAILABLE AT THIS TIME. REASON FOR REOPERATION: "PERI-IMPLANT FLUID ACCUMULATION".

Description of Event or Problem · 0

THIS REPORT HAS BEEN CONFIRMED AS A DUPLICATE OF MRN 9617229-2025-0000026 AND WAS INITIALLY REPORTED IN ERROR. SEE RELATED MRN FOR ALL RELEVANT INFORMATION.

Description of Event or Problem · 0

PATIENT REPORTED "PERI-IMPLANT FLUID ACCUMULATION" DIAGNOSED BY MRI AND ULTRASOUND. HEALTHCARE PROFESSIONAL CONFIRMS "FLUID COLLECTION, CAUSING LOCALIZED PAIN AND SYSTEMIC ILLNESS." AFFECTED SIDE IS RIGHT. THE DEVICE REMAINS IMPLANTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
64158 INSPIRA TEXTURED SILICONE GEL FILLED BREAST IMPLANT PROSTHESIS, BREAST, NONINFLATABLE, INTERNAL, SILICONE GEL-FILLED FTR ALLERGAN (COSTA RICA) 2700182

Patients

Seq Age Sex Outcome Treatment
1 24 YR Female Required Intervention