JUVEDERM VOLUX 2X1ML ROW
Report
- Report Number
- 3005113652-2025-00413
- Event Type
- Injury
- Date Received
- May 2, 2025
- Date of Event
- September 7, 2024
- Report Date
- May 2, 2025
- Manufacturer
- PRINGY
- Product Code
- LMH
- UDI-DI
- 7795316915751
- PMA / PMN Number
- P110033
- Adverse Event
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- MX
- Reporter Occupation
- PHYSICIAN
- Health Professional
- Yes
Narratives
CLARIFICATION TO H.6. TYPE OF INVESTIGATION CODE: THE FILLER WAS INJECTED INTO THE PATIENT AND IS NOT ACCESSIBLE FOR RETURN. THE SYRINGE WAS NOT RETURNED FOR EVALUATION. FURTHER INFORMATION REGARDING EVENT, PRODUCT, OR PATIENT DETAILS HAS BEEN REQUESTED. NO ADDITIONAL INFORMATION IS AVAILABLE AT THIS TIME. THE EVENT IS A PHYSIOLOGICAL COMPLICATION AND ANALYSIS OF THE DEVICE GENERALLY DOES NOT ASSIST ALLERGAN IN DETERMINING A PROBABLE CAUSE FOR THIS EVENT. 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. THIS IS A KNOWN POTENTIAL ADVERSE EVENT ADDRESSED IN THE PRODUCT LABELING.
HEALTHCARE PROFESSIONAL (HCP) REPORTED THAT A PATIENT INJECTED ON FIRST SESSION IN T1 (TEMPLE 0.5ML RIGHT, 0.7 ML LEFT ), CK1 (RIGHT 0.3 ML, 0.3 ML LEFT SIDE) & CK3 (0.3ML RIGHT SIDE, 0.5ML LEFT SIDE) WITH JUVÉDERM® VOLUMA¿ WITH LIDOCAINE, IN JW1 (0.5 ML RIGHT SIDE AND 0.5 ML LEFT SIDE) ,JW2 (0.5ML RIGHT SIDE, 0.5ML LEFT SIDE) WITH JUVÉDERM® VOLUX¿ AND IN C SHAPE (1.2ML ON EACH SIDE) WITH HARMONYCA¿. PATIENT HAVE EXPERIENCED "A TYPE OF DERMATITIS OR SCALING IN THE AREA WHERE HARMONYCA WAS ADMINISTERED." ADDITONAL INFORMATION PROVIDED, "ERYTHEMATOUS SQUAMOUS LESION IN THE APPLICATION AREA OF HYALURONIC ACID AND HARMONYCA (JW1, JW2 AND CK1) +, PRURIGINOUS +, WITHOUT EXUDATE, WITHOUT HEAT IN THE AREA." A COUPLE OF DAYS AFTER THE INJECTION, THE PATIENT REPORTS TO NOTICE MORE SEBUM PRODUCTION AT THE SKIN LEVEL. TWO DAYS LATER, ERYTHEMA, PRURITUS WITHOUT PAIN OR HEAT ARE ADDED TO THE AREA, WHICH RESOLVES WITH ADMINISTRATION OF 10 MG LORATADINE ORALLY FOR A SHORT PERIOD OF TIME AND RESOLVES THE CONDITION, ALSO ORAL ANTIHISTAMINES, LORATADINE 10 MG, LORATADINE WITH BETAMETHASONE. UNTIL, PATIENT REPORTED RECURRENCE OF ERYTHEMA, PRURITUS AND A THIN LAYER OF DESQUAMATION IN THE MIDDLE AREA OF THE CHEEK. THIS IS THE SAME EVENT AND THE SAME PATIENT REPORTED UNDER PATIENT IDENTIFIER (B)(6) (EMDR-(B)(4). THIS EMDR IS BEING SUBMITTED FOR THE SUSPECT PRODUCT, INJECTION IN JW1,JW2 (JAW) WITH JUVÉDERM® VOLUX¿.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 423681 | JUVEDERM VOLUX 2X1ML ROW | IMPLANT, DERMAL, FOR AESTHETIC USE | LMH | PRINGY | 1000567280 | 7795316915751 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 45 YR | Male | Required Intervention |