FDA Adverse Event Injury Summary report: N

STYLE 68 SALINE FILLED BREAST IMPLANT

MDR report key: 6909818 · Received October 3, 2017

Report

Report Number
9617229-2017-02801
Event Type
Injury
Date Received
October 3, 2017
Date of Event
September 11, 2017
Report Date
November 8, 2017
Manufacturer
ALLERGAN (COSTA RICA)
Product Code
FWM
PMA / PMN Number
P990074
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
MS, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

A REVIEW OF THE DEVICE HISTORY RECORD HAS BEEN COMPLETED. NO DEVIATIONS OR NON-CONFORMANCES NOTED. FURTHER INFORMATION FROM THE REPORTER REGARDING EVENT, PRODUCT, OR PATIENT DETAILS HAS BEEN REQUESTED. NO ADDITIONAL INFORMATION IS AVAILABLE AT THIS TIME. DEVICE LABELING: POTENTIAL ADVERSE EVENTS THAT MAY OCCUR WITH SALINE-FILLED BREAST IMPLANT SURGERY INCLUDE: REOPERATION, PAIN, WRINKLING, ASYMMETRY, IMPLANT PALPABILITY/VISIBILITY, IMPLANT REMOVAL, CAPSULAR CONTRACTURE, CHANGES IN NIPPLE AND BREAST SENSATION, IMPLANT DISPLACEMENT/MIGRATION, IMPLANT DEFLATION, SCARRING, INFECTION, HEMATOMA/SEROMA, BREASTFEEDING COMPLICATIONS, IMPLANT EXTRUSION, NECROSIS, DELAYED WOUND HEALING, BREAST TISSUE ATROPHY/CHEST WALL DEFORMITY, CALCIUM DEPOSITS, AND LYMPHADENOPATHY. DEFLATION ¿ BREAST IMPLANTS ARE NOT LIFETIME DEVICES. SALINE BREAST IMPLANTS DEFLATE WHEN THE SHELL DEVELOPS A TEAR OR HOLE. DEFLATION CAN OCCUR AT ANY TIME AFTER IMPLANTATION, BUT THEY ARE MORE LIKELY TO OCCUR THE LONGER THE IMPLANT IS IMPLANTED. THE FOLLOWING THINGS MAY CAUSE IMPLANTS TO DEFLATE: DAMAGE BY SURGICAL INSTRUMENTS; FOLDING OR WRINKLING OF THE IMPLANT SHELL; EXCESSIVE FORCE TO THE CHEST (E.G., DURING CLOSED CAPSULOTOMY, WHICH IS CONTRAINDICATED); TRAUMA; COMPRESSION DURING MAMMOGRAPHIC IMAGING; AND SEVERE CAPSULAR CONTRACTURE. BREAST IMPLANTS MAY ALSO SIMPLY WEAR OUT OVER TIME. LABORATORY STUDIES HAVE IDENTIFIED SOME OF THE CAUSES OF DEFLATION FOR ALLERGAN¿S PRODUCT; HOWEVER, IT IS NOT CONCLUSIVELY KNOWN WHETHER THESE TESTS HAVE IDENTIFIED ALL CAUSES OF DEFLATION.

Additional Manufacturer Narrative · 1

DEVICE EVALUATION: THE DEVICE RELATED TO THE REPORTED EVENT OF DEFLATION RECEIVED ON (B)(6) 2017 WITH LOT NUMBER 1820404. VISUAL ANALYSIS OF THE RETURNED DEVICE IDENTIFIED: OPENING, WEAR ABRASION, CREASE FOLD AND WHITE PARTICLES. LEAK TEST WAS PERFORMED AND FOUND OPENING ON POSTERIOR. A MICROSCOPIC ANALYSIS WAS PERFORMED WHICH IDENTIFY CREASE SMOOTH OPENING ON POSTERIOR. THE FILL TEST INSPECTION WAS PERFORMED, THE RESULT IS NO BLOCKAGE BASED ON THE DEVICE ANALYSIS THE FINAL ASSESSMENT IS: A CREASE SMOOTH OPENING ON POSTERIOR DUE TO AN FOLD FLAW OPENING.

Description of Event or Problem · 1

HEALTHCARE PROFESSIONAL REPORTED A LEFT SIDE DEFLATION. DEVICE HAS BEEN EXPLANTED.

Description of Event or Problem · 1

HEALTHCARE PROFESSIONAL REPORTED A LEFT SIDE DEFLATION. DEVICE HAS BEEN EXPLANTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
690341 STYLE 68 SALINE FILLED BREAST IMPLANT PROSTHESIS, BREAST, INFLATABLE, INTERNAL, SALINE FWM ALLERGAN (COSTA RICA) 1820404

Patients

Seq Age Sex Outcome Treatment
1 59 YR Required Intervention