FDA Adverse Event
Injury
Summary report: N
CUI STYLE RHP SILICONE GEL FILLED BREAST IMPLANT
MDR report key: 22352140
·
Received June 27, 2025
Report
- Report Number
- 9617229-2025-10778
- Event Type
- Injury
- Date Received
- June 27, 2025
- Report Date
- June 27, 2025
- Manufacturer
- ALLERGAN (COSTA RICA)
- Product Code
- FTR
- PMA / PMN Number
- PREAMEND
- Adverse Event
- Yes
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- SP
- Reporter Occupation
- PHYSICIAN
- Health Professional
- Yes
Narratives
Additional Manufacturer Narrative · 0
CLARIFICATION TO D6A IMPLANT DATE: PARTIAL DATE 2018. THE EVENT OF "SEROMA-LATE" IS A PHYSIOLOGICAL COMPLICATION AND ANALYSIS OF THE DEVICE GENERALLY DOES NOT ASSIST ABBVIE 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: "INTRACAPSULAR RUPTURE"; "SUDDEN SEROMA OF MORE THAN 200CC."
Description of Event or Problem · 0
HEALTHCARE PROFESSIONAL REPORTED UNKNOWN SIDE "INTRACAPSULAR RUPTURE AND SUDDEN SEROMA OF MORE THAN 200CC". THIS RECORD IS FOR THE RIGHT SIDE. DEVICE REMAINS IMPLANTED.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1855884 | CUI STYLE RHP SILICONE GEL FILLED BREAST IMPLANT | PROSTHESIS, BREAST, NONINFLATABLE, INTERNAL, SILICONE GEL-FILLED | FTR | ALLERGAN (COSTA RICA) | NI |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | NA | Female | Required Intervention |