JUVEDERM VOLUMA XC/LIDO (VOLUME UNKNOWN)
Report
- Report Number
- 3005113652-2025-00787
- Event Type
- Injury
- Date Received
- September 4, 2025
- Date of Event
- August 18, 2025
- Report Date
- September 4, 2025
- Manufacturer
- ALLERGAN (PRINGY)
- Product Code
- LMH
- PMA / PMN Number
- P110033
- Adverse Event
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- GA, US
- 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. THIS IS A KNOWN POTENTIAL ADVERSE EVENT ADDRESSED IN THE PRODUCT LABELING.
HEALTHCARE PROFESSIONAL (HCP) REPORTED INJECTING A PATIENT WITH 2CC OF JUVÉDERM® VOLUMA® XC IN THE CHEEKS AND 0.5CC OF JUVÉDERM® VOLBELLA® XC IN THE LIPS. PATIENT IS EXPERIENCING "DELAYED NODULES". HCP LATER REPORTED ABOUT 2 MONTHS POST INJECTION, PATIENT SYMPTOMS STARTED "AS SMALL, SLIGHTLY PALPABLE, MILDLY TENDER NODULE IN UPPER RIGHT LIP AND MILD SWELLING UNDER RIGHT EYE IN MIDFACE AREA. PROGRESSED TO MODERATE TO SEVERE SWELLING OF THE ENTIRE UPPER LIP AND UNDER BOTH EYES/MID CHEEK AREA". TWO DAYS POST SYMPTOM ONSET, PATIENT WAS TREATED WITH DOXYCYCLINE 100MG PO BID X 14 DAYS AND PREDNISONE 20MG PO ONCE DAILY X 5 DAYS. HCP LATER REPORTED THE PATIENT EXPERIENCED A NON-DEVICE RELATED SINUS INFECTION AROUND THE TIME OF THE ONSET OF EDEMA. SYMPTOMS ARE ONGOING. THIS WAS THE INITIAL USE OF THE SYRINGE. THE PACKAGED NEEDLE WAS USED. THIS IS THE SAME EVENT AND THE SAME PATIENT REPORTED UNDER ABBVIE COMPLAINT (B)(6); (EMDR-101749). THIS MDR IS BEING SUBMITTED FOR THE FIRST SUSPECT PRODUCT, JUVÉDERM® VOLUMA® XC. THIS IS THE SAME EVENT AND THE SAME PATIENT REPORTED UNDER EMDR- 101752. THIS EMDR IS BEING SUBMITTED FOR THE SERIOUS INJURY.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1809008 | JUVEDERM VOLUMA XC/LIDO (VOLUME UNKNOWN) | IMPLANT, DERMAL, FOR AESTHETIC USE | LMH | ALLERGAN (PRINGY) | NI |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 30 YR | Female | Required Intervention |