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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ALLERGAN (COSTA RICA) INSPIRA SMOOTH SILICONE GEL FILLED BREAST IMPLANT; PROSTHESIS, BREAST, NONINFLATABLE, INTERNAL, SILICONE GEL-FILLED

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ALLERGAN (COSTA RICA) INSPIRA SMOOTH SILICONE GEL FILLED BREAST IMPLANT; PROSTHESIS, BREAST, NONINFLATABLE, INTERNAL, SILICONE GEL-FILLED Back to Search Results
Catalog Number N-SSX310
Device Problems Device Appears to Trigger Rejection (1524); No Apparent Adverse Event (3189)
Patient Problems Capsular Contracture (1761); No Clinical Signs, Symptoms or Conditions (4582)
Event Date 10/16/2023
Event Type  Injury  
Manufacturer Narrative
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.The event of capsular contracture is a physiological complication and analysis of the device generally does not assist allergan in determining a probable cause for this event.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: capsular contracture baker grade iii.
 
Event Description
Healthcare professional reported right side capsular contracture baker grade iii.Device remains implanted.
 
Event Description
Healthcare professional later reported that the event of capsular contracture was confirmed to not have occurred.This record is no longer reportable to the fda and will be un-reported.
 
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Brand Name
INSPIRA SMOOTH SILICONE GEL FILLED BREAST IMPLANT
Type of Device
PROSTHESIS, BREAST, NONINFLATABLE, INTERNAL, SILICONE GEL-FILLED
Manufacturer (Section D)
ALLERGAN (COSTA RICA)
900 parkway global park
zona franca
la aurora de heredia
CS 
Manufacturer (Section G)
ALLERGAN (COSTA RICA)
900 parkway global park
zona franca
la aurora de heredia
CS  
Manufacturer Contact
terry ingram
12331-a riata trace parkway
building 3
austin, TX 78727
8479366324
MDR Report Key18355046
MDR Text Key330876829
Report Number9617229-2023-32136
Device Sequence Number1
Product Code FTR
Combination Product (y/n)N
Reporter Country CodeCA
PMA/PMN Number
P020056
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Foreign,Health Professional,Company Representative
Reporter Occupation Physician
Type of Report Initial,Followup
Report Date 02/02/2024
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received12/19/2023
Is this an Adverse Event Report? Yes
Is this a Product Problem Report? No
Device Operator Health Professional
Device Catalogue NumberN-SSX310
Device Lot Number3428117
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Date Manufacturer Received01/16/2024
Was Device Evaluated by Manufacturer? Device Not Returned to Manufacturer
Date Device Manufactured03/30/2020
Is the Device Single Use? Yes
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Initial
Patient Sequence Number1
Patient Outcome(s) Required Intervention;
Patient Age49 YR
Patient SexFemale
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