STYLE 410 COHESIVE SILICONE GEL FILLED BREAST IMPLANT
Report
- Report Number
- 9617229-2026-03938
- Event Type
- Injury
- Date Received
- March 3, 2026
- Date of Event
- January 23, 2026
- Report Date
- April 9, 2026
- Manufacturer
- ALLERGAN (COSTA RICA)
- Product Code
- FTR
- UDI-DI
- 5060191601238
- PMA / PMN Number
- P040046
- Adverse Event
- Yes
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- IT
- Reporter Occupation
- PHYSICIAN
- Health Professional
- Yes
Narratives
CONTINUE: E.1. ZIP CODE: (B)(6). 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. 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.
A REVIEW OF THE DEVICE HISTORY RECORD HAS BEEN COMPLETED. NO DEVIATIONS OR NON-CONFORMANCES NOTED.
HEALTHCARE PROFESSIONAL REPORTED "RUPTURED BREAST PROSTHESIS" THROUGH THE MOH (MINISTRY OF HEALTH). THIS RECORD IS FOR THE RIGHT SIDE. DEVICE WAS EXPLANTED.
HEALTHCARE PROFESSIONAL REPORTED "RUPTURED BREAST PROSTHESIS" THROUGH THE MOH (MINISTRY OF HEALTH). THIS RECORD IS FOR THE RIGHT SIDE. DEVICE WAS EXPLANTED.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 205686 | STYLE 410 COHESIVE SILICONE GEL FILLED BREAST IMPLANT | PROSTHESIS, BREAST, NONINFLATABLE, INTERNAL, SILICONE GEL-FILLED | FTR | ALLERGAN (COSTA RICA) | 2583759 | 5060191601238 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 50 YR | Unknown | Required Intervention |