FDA Adverse Event Injury Summary report: N

JUVEDERM VOLUMA XC/LIDO (VOLUME UNKNOWN)

MDR report key: 3812805 · Received May 6, 2014

Report

Report Number
3005113652-2014-00185
Event Type
Injury
Date Received
May 6, 2014
Date of Event
March 10, 2014
Report Date
April 9, 2014
Manufacturer
ALLERGAN
Product Code
LMH
PMA / PMN Number
P110033
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
CA
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

FURTHER INFORMATION FROM THE REPORTER REGARDING EVENT, PRODUCT, OR PATIENT DETAILS HAVE BEEN REQUESTED. HEALTHCARE PROFESSIONAL INDICATED THEY DID NOT RECORD THE LOT NUMBER. THE EVENTS OF FIRMNESS, TENDERNESS, AND SWELLING ARE PHYSIOLOGICAL COMPLICATIONS AND ANALYSIS OF THE DEVICE GENERALLY DOES NOT ASSIST ALLERGAN IN DETERMINING A PROBABLE CAUSE FOR THESE EVENTS.

Description of Event or Problem · 1

HEALTHCARE PROFESSIONAL REPORTED 3 MONTHS AFTER INJECTION WITH EIGHT SYRINGES OF JUVEDERM VOLUMA WITH LIDOCAINE IN THE TEAR TROUGHS, CHEEKS, LOWER FACE, AND JOWLS, PATIENT EXPERIENCED FIRMNESS, TENDERNESS, AND SWELLING IN THE LOWER FACE, INCLUDING THE MENTUM, CHEEKS, AND LIPS. PATIENT WAS TREATED WITH HYALURONIDASE AND PREDNISONE; AND SYMPTOMS RESOLVED APPROXIMATELY 3.5 WEEKS AFTER ONSET.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
271434 JUVEDERM VOLUMA XC/LIDO (VOLUME UNKNOWN) LMH ALLERGAN NA

Patients

Seq Age Sex Outcome Treatment
1 63 YR Required Intervention