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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 SRF-485
Device Problem Patient-Device Incompatibility (2682)
Patient Problems Wound Dehiscence (1154); Foreign Body Reaction (1868)
Event Date 01/15/2023
Event Type  Injury  
Event Description
Patient reported left side "kept falling out" and "my sutures kept breaking open".The device has been explanted.
 
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 "wound dehiscence and exposure" 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: wound dehiscence and exposure.
 
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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 Key18789601
MDR Text Key336347100
Report Number9617229-2024-03232
Device Sequence Number1
Product Code FTR
Combination Product (y/n)N
Reporter Country CodeUS
PMA/PMN Number
P020056
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Consumer
Reporter Occupation Other
Type of Report Initial
Report Date 02/27/2024
1 Device was Involved in the Event
1 Patient was Involved in the Event
Is this an Adverse Event Report? Yes
Is this a Product Problem Report? No
Device Operator Health Professional
Device Catalogue NumberSRF-485
Device Lot Number3620717
Was Device Available for Evaluation? No
Initial Date Manufacturer Received 02/05/2024
Initial Date FDA Received02/27/2024
Was Device Evaluated by Manufacturer? Device Not Returned to Manufacturer
Date Device Manufactured06/15/2022
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 Age45 YR
Patient SexFemale
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