FDA Adverse Event Injury Summary report: N

INSPIRA SMOOTH SILICONE GEL FILLED BREAST IMPLANT

MDR report key: 21340537 · Received February 8, 2025

Report

Report Number
9617229-2025-02188
Event Type
Injury
Date Received
February 8, 2025
Date of Event
January 24, 2025
Report Date
February 8, 2025
Manufacturer
ALLERGAN (COSTA RICA)
Product Code
FTR
PMA / PMN Number
P020056
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
TX, US
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

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

ADDITIONAL, CHANGED, AND/OR CORRECTED DATA: D9, H3, H6. DEVICE EVALUATION: THE DEVICE RELATED TO THE REPORTED EVENT OF RUPTURE WAS RECEIVED ON MARCH 03, 2025, WITH LOT NUMBER 2830234. BASED ON THE PRODUCT ANALYSIS PERFORMED, THE ASSESSMENTS OF THE COMPLAINTS ARE: ¿ RUPTURE: OBSERVED, BROKEN ASSESSED AS FOLD FLAW OPENING. AS PER THE INVESTIGATION PROCEDURE, CREASE AND NON-PENETRATING NICK WERE COMPLETED AND NONE OF THE OBSERVATIONS ARE FOUND TO BE POTENTIALLY RELATED TO THE MANUFACTURING PROCESS, NO FURTHER ACTIONS ARE REQUIRED.

Description of Event or Problem · 0

HEALTHCARE PROFESSIONAL REPORTED LEFT-SIDE "RUPTURE AND TOTALLY DISRUPTED". DEVICE HAS BEEN EXPLANTED AND REPLACED.

Description of Event or Problem · 0

HEALTHCARE PROFESSIONAL REPORTED LEFT-SIDE "RUPTURE AND TOTALLY DISRUPTED". DEVICE HAS BEEN EXPLANTED AND REPLACED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
126324 INSPIRA SMOOTH SILICONE GEL FILLED BREAST IMPLANT PROSTHESIS, BREAST, NONINFLATABLE, INTERNAL, SILICONE GEL-FILLED FTR ALLERGAN (COSTA RICA) 2830234

Patients

Seq Age Sex Outcome Treatment
1 42 YR Female Required Intervention