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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ALLERGAN (PRINGY) JUVEDERM ULTRA PLUS XC/LIDO (VOLUME UNKNOWN); IMPLANT, DERMAL, FOR AESTHETIC USE

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ALLERGAN (PRINGY) JUVEDERM ULTRA PLUS XC/LIDO (VOLUME UNKNOWN); IMPLANT, DERMAL, FOR AESTHETIC USE Back to Search Results
Catalog Number UNK JUVEDERM ULTRAPLUS XC/LIDO
Device Problem Adverse Event Without Identified Device or Use Problem (2993)
Patient Problems Asthma (1726); Bronchitis (1752); Pneumonia (2011)
Event Date 07/15/2020
Event Type  Injury  
Manufacturer Narrative
Further information regarding event, product, or patient details has been requested.No additional information is available at this time.The event is a physiological complication and analysis of the device generally does not assist allergan in determining a probable cause for this event.The events of "asthma, bronchitis and pneumonia" are deemed not device related but are considered unexpected adverse drug experiences.
 
Event Description
Healthcare professional reported a patient was injected with 1.0 cc of juvéderm voluma® xc and 1.0 cc of juvéderm volbella® xc in the cheeks and nasolabial.Five months later, patient was injected with 1.0 cc juvéderm voluma® xc in the cheeks.Seven months later, patient was injected with 1.0 cc juvéderm® ultra plus xc in cheeks.Approximately seven months later, patient developed asthma, pneumonia, and bronchitis and was given prednisone on a tapering regiment for 6 months, deemed not related to the device.Three months later, patient was injected with 1.0 cc juvéderm voluma® xc in the checks and 1.0 cc juvéderm volbella® xc in the infraorbital hollow.Three months later, patient developed firmness throughout the cheeks and watery edema in the malar bag region.Patient was treated with doxycycline and hylenex® was administered to remove some product from the cheeks ¿ this improved the edema slightly.Patient has weekly assessments at clinic and is also taking singulair®.Patient is taking alternating doses of 2 and 4mg prednisone od.It was also noted that patient had restylane on an unknown date and have had other unknown fillers in the past six years.Symptoms are improving but ongoing.This is the same event and the same patient reported under mdr id# 3005113652-2021-00046 (allergan complaint #(b)(4)), mdr id# 3005113652-2021-00046 (allergan complaint #(b)(4)), and mdr id# 3005113652-2021-00026 (allergan complaint #(b)(4)).This mdr is being submitted for the fourth suspect product, juvéderm® ultra plus xc.
 
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Brand Name
JUVEDERM ULTRA PLUS XC/LIDO (VOLUME UNKNOWN)
Type of Device
IMPLANT, DERMAL, FOR AESTHETIC USE
Manufacturer (Section D)
ALLERGAN (PRINGY)
route de promery
zone artisanale de pre-mairy
pringy
Manufacturer (Section G)
ALLERGAN (PRINGY)
route de promery
zone artisanale de pre-mairy
pringy
Manufacturer Contact
michelle burgess
12331-a riata trace parkway
building 3
austin, TX 
7372473605
MDR Report Key11273769
MDR Text Key230093471
Report Number3005113652-2021-00041
Device Sequence Number1
Product Code LMH
Combination Product (y/n)N
Reporter Country CodeUS
PMA/PMN Number
P050047
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type company representative,health
Reporter Occupation Physician
Type of Report Initial
Report Date 02/03/2021
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received02/03/2021
Is this an Adverse Event Report? Yes
Is this a Product Problem Report? No
Device Operator Health Professional
Device Catalogue NumberUNK JUVEDERM ULTRAPLUS XC/LIDO
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Date Manufacturer Received01/12/2021
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 Age51 YR
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