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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ALLERGAN (COSTA RICA) UNK CUI TISSUE EXPANDER; EXPANDER, SKIN, INFLATABLE

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ALLERGAN (COSTA RICA) UNK CUI TISSUE EXPANDER; EXPANDER, SKIN, INFLATABLE Back to Search Results
Catalog Number UNK CUI TISSUE EXPANDER
Device Problem Patient-Device Incompatibility (2682)
Patient Problems Wound Dehiscence (1154); Hemorrhage/Bleeding (1888); Necrosis (1971)
Event Type  Injury  
Event Description
Japanese breast cancer society reported 33 cases of "nipple areolar necrosis", "skin necrosis at the incision site or skin flap", "te exposure from the skin necrosis site", "wound dehiscence", "replaced due to upper deviation of the implant", "pain or discomfort" and "postoperative hemorrhage/hematoma".Devices placement are unknown.
 
Manufacturer Narrative
The events of hemorrhage, wound dehiscence , necrosis and exposure are 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: hemorrhage, wound dehiscence , necrosis and exposure.
 
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Brand Name
UNK CUI TISSUE EXPANDER
Type of Device
EXPANDER, SKIN, INFLATABLE
Manufacturer (Section D)
ALLERGAN (COSTA RICA)
900 parkway global park
zona franca
Manufacturer (Section G)
ALLERGAN (COSTA RICA)
900 parkway global park
zona franca
Manufacturer Contact
terry ingram
12331-a riata trace parkway
building 3
austin, TX 78727
8479366324
MDR Report Key17383157
MDR Text Key319738109
Report Number9617229-2023-12459
Device Sequence Number1
Product Code LCJ
Combination Product (y/n)N
Reporter Country CodeJA
PMA/PMN Number
K865056
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Foreign,Company Representative
Reporter Occupation Other
Type of Report Initial
Report Date 07/24/2023
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received07/24/2023
Is this an Adverse Event Report? Yes
Is this a Product Problem Report? No
Device Operator Health Professional
Device Catalogue NumberUNK CUI TISSUE EXPANDER
Was Device Available for Evaluation? No
Date Manufacturer Received06/29/2023
Was Device Evaluated by Manufacturer? Device Not Returned to Manufacturer
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 SexFemale
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