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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ALLERGAN (PRINGY) JUVEDERM (VOLUME/CONCENTRATION/ADDITIVE UNKNOWN); IMPLANT, DERMAL, FOR AESTHETIC USE

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ALLERGAN (PRINGY) JUVEDERM (VOLUME/CONCENTRATION/ADDITIVE UNKNOWN); IMPLANT, DERMAL, FOR AESTHETIC USE Back to Search Results
Catalog Number UNK JUVEDERM-CONC/ADD
Device Problem Adverse Event Without Identified Device or Use Problem (2993)
Patient Problem Cytomegalovirus (CMV) Infection (2220)
Event Type  Injury  
Manufacturer Narrative
Further information from the reporter regarding event, product, or patient details has been requested.No additional information is available at this time.The events are physiological complications and analysis of the device generally does not assist allergan in determining a probable cause for these events.The filler was injected into the patient and is not accessible for return.The syringe was not returned for evaluation.This is a known potential adverse event addressed in the product labeling.
 
Event Description
Patient reported that they were injected with an unspecified juvéderm® and experienced a ¿cold sore.".
 
Event Description
Patient reported that they were injected with an unspecified juvéderm® and experienced a ¿cold sore.".
 
Manufacturer Narrative
Additional, changed, and/or corrected data: b.7.
 
Manufacturer Narrative
This medwatch is being submitted to correct g.3.For the initial medwatch submitted on 23/aug/2021.The aware date is 06/may/2021, not 29/jul/2021.
 
Event Description
Patient reported that they were injected with an unspecified juvéderm® and experienced a ¿cold sore.".
 
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Brand Name
JUVEDERM (VOLUME/CONCENTRATION/ADDITIVE UNKNOWN)
Type of Device
IMPLANT, DERMAL, FOR AESTHETIC USE
Manufacturer (Section D)
ALLERGAN (PRINGY)
route de promery
zone artisanale de pre-mairy
pringy
MDR Report Key12355984
MDR Text Key267751429
Report Number3005113652-2021-03152
Device Sequence Number1
Product Code LMH
Combination Product (y/n)N
PMA/PMN Number
P050047
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type company representative,consum
Type of Report Initial,Followup,Followup
Report Date 09/24/2021
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received08/23/2021
Is this an Adverse Event Report? Yes
Is this a Product Problem Report? No
Device Operator Health Professional
Device Catalogue NumberUNK JUVEDERM-CONC/ADD
Was Device Available for Evaluation? No
Date Manufacturer Received09/14/2021
Is This a Reprocessed and Reused Single-Use Device? No
Patient Sequence Number1
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