FDA Adverse Event Injury Summary report: N

VOLBELLA WITH LIDOCAINE

MDR report key: 6052231 · Received October 24, 2016

Report

Report Number
3005113652-2016-00866
Event Type
Injury
Date Received
October 24, 2016
Date of Event
May 10, 2016
Manufacturer
ALLERGAN (PRINGY)
Product Code
LMH
PMA / PMN Number
P110033
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
SF
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

DEVICE HISTORY RECORD SUMMARY: THE DOCUMENTARY RESEARCH IN THE BATCH FILE SHOWS THAT NO ELEMENT COULD EXPLAIN THESE REACTIONS: ALL THE MANUFACTURING STEPS AND ALL THE PHYSICOCHEMICAL AND MICROBIOLOGICAL RESULTS (ENDOTOXINS, BIOBURDEN) ARE REGISTERED AS CONFORMING TO THE SPECIFICATIONS. THE STERILIZATION CYCLE IS REGISTERED AS CONFORMING.

Additional Manufacturer Narrative · 1

CONCOMITANT THERAPIES: JUVÉDERM® VOLUMA¿ WITH LIDOCAINE; PRETREATMENT: HIBIDIL AND LIDOCAINE; POST TREATMENT: GEL ICE PACKS. FURTHER INFORMATION FROM THE REPORTER REGARDING EVENT, PRODUCT, OR PATIENT DETAILS HAS BEEN REQUESTED. NO ADDITIONAL INFORMATION IS AVAILABLE AT THIS TIME. THE EVENT OF NODULAR SWELLING IS A PHYSIOLOGICAL COMPLICATION AND ANALYSIS OF THE DEVICE GENERALLY DOES NOT ASSIST ALLERGAN IN DETERMINING A PROBABLE CAUSE FOR THIS EVENT. DEVICE LABELING ADDRESSES THE REPORTED EVENT OF NODULAR SWELLING AS FOLLOWS: UNDESIRABLE EFFECTS: "THE PATIENTS MUST BE INFORMED THAT THERE ARE POTENTIAL SIDE EFFECTS ASSOCIATED WITH IMPLANTATION OF THIS DEVICE, WHICH MAY OCCUR IMMEDIATELY OR MAY BE DELAYED. THESE INCLUDE (NON-EXHAUSTIVE LIST): ¿ INFLAMMATORY REACTIONS (REDNESS, OEDEMA, ERYTHEMA, ...) WHICH MAY BE ASSOCIATED WITH ITCHING, PAIN ON PRESSURE, OCCURRING AFTER THE INJECTION. THESE REACTIONS MAY LAST FOR A WEEK. IN PARTICULAR, IT HAS TO BE NOTICED THAT INJECTION IN THE MUCOUS MEMBRANE MAY CAUSE MORE OEDEMA AND BRUISING DUE TO THE SPECIFIC PHYSIOLOGY OF THESE TISSUES. BESIDES, A PREVENTATIVE ANTI-INFLAMMATORY TREATMENT BY A MEDICAL PRACTITIONER CAN BE RECOMMENDED. ¿ INDURATION OR NODULES AT THE INJECTION SITE."

Description of Event or Problem · 1

HEALTHCARE PROFESSIONAL REPORTED PATIENT WAS INJECTED TO THE CHEEKS AND TEMPORAL WITH 2.5ML OF JUVÉDERM® VOLUMA" WITH LIDOCAINE, TO THE MOUTH CORNER, LABIOMENTAL, CHEEKS, NASOLABIAL, MARIONETTE, BROW, KEN, [ILLEGIBLE], GMG, AND MASSETER WITH 6ML OF JUVÉDERM® VOLIFT" WITH LIDOCAINE, AND TO THE LIPS WITH 0.8ML OF JUVÉDERM® VOLBELLA" WITH LIDOCAINE. PATIENT WAS ALSO CONCOMITANTLY INJECTED WITH BOTOX®. PRIOR TO INJECTION PATIENT WAS PRETREATED WITH HIBIDIL AND LIDOCAINE AND AFTER INJECTION PATIENT USE GEL ICE PACKS. APPROXIMATELY 10 WEEKS LATER PATIENT DEVELOPED NODULAR SWELLING IN ALL TREATED AREAS. PATIENT WAS PRESCRIBED ORAL ANTIBIOTICS (AVALON) AND ORAL STEROID (METICORTEN). SYMPTOMS RESOLVED 2 MONTHS LATER. THIS IS THE SAME EVENT AND THE SAME PATIENT REPORTED UNDER MDR ID #3005113652-2016-00865 ((B)(4)). THIS MDR IS BEING SUBMITTED FOR THE SECOND SUSPECT PRODUCT, JUVÉDERM® VOLBELLA" WITH LIDOCAINE, ALSO A DEVICE MANUFACTURED BY ALLERGAN.

Description of Event or Problem · 1

HEALTHCARE PROFESSIONAL REPORTED PATIENT WAS INJECTED TO THE CHEEKS AND TEMPORAL WITH 2.5ML OF JUVÉDERM® VOLUMA¿ WITH LIDOCAINE, TO THE MOUTH CORNER, LABIOMENTAL, CHEEKS, NASOLABIAL, MARIONETTE, BROW, ¿KEN¿, [ILLEGIBLE], ¿GMG¿, AND MASSETER WITH 6ML OF JUVÉDERM® VOLIFT¿ WITH LIDOCAINE, AND TO THE LIPS WITH 0.8ML OF JUVÉDERM® VOLBELLA¿ WITH LIDOCAINE. PATIENT WAS ALSO CONCOMITANTLY INJECTED WITH BOTOX®. PRIOR TO INJECTION PATIENT WAS PRETREATED WITH HIBIDIL AND LIDOCAINE AND AFTER INJECTION PATIENT USE GEL ICE PACKS. APPROXIMATELY 10 WEEKS LATER PATIENT DEVELOPED NODULAR SWELLING IN ALL TREATED AREAS. PATIENT WAS PRESCRIBED ORAL ANTIBIOTICS (AVALON) AND ORAL STEROID (METICORTEN). SYMPTOMS RESOLVED 2 MONTHS LATER. THIS IS THE SAME EVENT AND THE SAME PATIENT REPORTED UNDER MDR ID #3005113652-2016-00865 ((B)(4)). THIS MDR IS BEING SUBMITTED FOR THE SECOND SUSPECT PRODUCT, JUVÉDERM® VOLBELLA¿ WITH LIDOCAINE, ALSO A DEVICE MANUFACTURED BY ALLERGAN.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
701428 VOLBELLA WITH LIDOCAINE IMPLANT, DERMAL, FOR AESTHETIC USE LMH ALLERGAN (PRINGY) V15LA50273

Patients

Seq Age Sex Outcome Treatment
1 51 YR Required Intervention JUVÉDERM® VOLIFT¿ WITH LIDOCAINE, BOTOX®