FDA Adverse Event Injury Summary report: N

NATRELLE SILICONE-FILLED BREAST IMPLANTS

MDR report key: 3736682 · Received April 2, 2014

Report

Report Number
3736682
Event Type
Injury
Date Received
April 2, 2014
Date of Event
March 4, 2014
Report Date
April 1, 2014
Manufacturer
ALLERGAN
Product Code
FTR
Adverse Event
Yes
Product Problem
Yes
Report Source
User Facility report
Reporter Location
NY, US
Reporter Occupation
RISK MANAGER

Narratives

Description of Event or Problem · 1

FORTY SEVEN YEAR OLD FEMALE ADMITTED FOR EXPLANTATION OF BILATERAL SILICONE IMPLANTS ON (B)(6) 2014. PAST MEDICAL HISTORY: MOTION SICKNESS, MIGRAINES, HIATAL HERNIA, GASTRO REFLUX DISEASE, BREAST CANCER (MULTIFOCAL LOBULAR CARCINOMA IN SITU). PAST SURGICAL HISTORY: BILATERAL MASTECTOMY'S . (B)(6) 2013: EXCHANGE OF TISSUE EXPANDERS FOR PERMANENT BREAST IMPLANTS BILATERALLY. UNDER SPECIMENS - 2 TISSUE EXPANDERS REMOVED AND DISCARDED. NATRELLE MODEL #10-300, SMOOTH SILICONE FILLED ROUND MODERATE PROFILE BREAST IMPLANTS PER OPERATIVE REPORT. PER NURSING INTRA-OP RECORD - 2 TISSUE EXPANDERS REMOVED AND DISCARDED. RIGHT BREAST: MAMMARY SILICONE NATRELLE 300CC, ALLERGAN USA INC. SERIAL # (B)(4). LEFT BREAST MAMMARY SILICONE NATRELLE 300CC MODERATE PROFILE, ALLERGAN USA INC. SERIAL # (B)(4). (B)(6) 2013: A REPORT WAS FILED WITH ALLERGAN, BY A HEALTHCARE PROFESSIONAL WHO REPORTED LEFT SIDE "DIFFUSE BODY EDEMA, MALAISE, EXTREME WEIGHT GAIN, INABILITY TO SLEEP, EXTREME CHANGES AND FLUCTUATIONS IN BLOOD PRESSURE AND ASYMMETRICAL DENSITY". A CASE FILE WAS OPENED UP BY ALLERGAN. REFERENCE # (B)(4), CATALOG # 10-300, SERIAL # (B)(4). (B)(6) 2013: MRI OF THE BREASTS WAS COMPLETED TO CHECK FOR IMPLANT RUPTURE. MRI REVEALED SOME WHAT CONCERNING CONFIGURATION OF THE POSTERIOR WALL OF THE RIGHT BREAST IMPLANT WITH WHAT IS POSSIBLY A PROMINENT RADIAL FOLD. IT DOES APPEAR TO BE ASYMMETRIC AS COMPARED TO THE LEFT SIDE. (B)(6) 2014: PT HAVING SYSTEMIC CHANGES INCLUDING DIFFUSE MUSCLE ACHING AND TIREDNESS. CHEST DISCOMFORT AND QUESTION OF CEREBROVASCULAR ACCIDENT SYMPTOMS ALL OF WHICH WERE PROVEN TO BE NEGATIVE. REMOVAL OF BILATERAL BREAST IMPLANTS AND MASTECTOMY SCAR REVISION PER OPERATIVE NOTE. PER NURSING INTRA-OP RECORD-REMOVAL BILATERAL BREAST IMPLANTS, REVISION OF MASTECTOMY SCARS, REMOVAL EXPANDER TISSUE BREAST. UNDER SPECIMENS- IMPLANTS REMOVED AND DISCARDED #1.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
199835 NATRELLE SILICONE-FILLED BREAST IMPLANTS SILICONE BREAST IMPLANTS FTR ALLERGAN 10-300
199836 NATRELLE SILICONE-FILLED BREAST IMPLANTS SILICONE BREAST IMPLANTS FTR ALLERGAN 10-300

Patients

Seq Age Sex Outcome Treatment
1 47 YR Required Intervention ADD'L INFO TO #10 ABOVE: ONLY ONE IMPLANT RETURNED| TO COMPANY, THE OTHER WAS INADVERTENTLY DISCARDED.