• Decrease font size
  • Return font size to normal
  • Increase font size
U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ALLERGAN (PRINGY) VOLBELLA WITH LIDOCAINE; IMPLANT, DERMAL, FOR AESTHETIC USE

  • Print
  • Share
  • E-mail
-
Super Search Devices@FDA
510(k) | DeNovo | Registration & Listing | Adverse Events | Recalls | PMA | HDE | Classification | Standards
CFR Title 21 | Radiation-Emitting Products | X-Ray Assembler | Medsun Reports | CLIA | TPLC
 

ALLERGAN (PRINGY) VOLBELLA WITH LIDOCAINE; IMPLANT, DERMAL, FOR AESTHETIC USE Back to Search Results
Model Number 95834 
Device Problem Adverse Event Without Identified Device or Use Problem (2993)
Patient Problems Respiratory Tract Infection (2420); Nodule (4551)
Event Date 08/02/2017
Event Type  Injury  
Event Description
Healthcare professional reported in the article ¿radial sound (shockwave) therapy resolves delayed-onset nodules following injection of hyaluronic acid dermal filler: a case study¿ that a patient was injected in the cheeks and midface with juvéderm® voluma¿ xc and in the perioral rhytids with juvéderm® volbella¿ xc.Three months later, the patient experienced ¿five circumoral nodules¿ bilaterally in the oral commissures that were not visible but could be detected by palpation.The patient reported that the nodules felt ¿hot and tight¿ under the skin.The patient also reported to have experienced a non-device related ¿upper respiratory infection¿ two weeks before the nodules appeared, but was afebrile upon presentation, with no systemic signs of infection; thus, an infectious etiology was not suspected regarding the nodules.The patient was treated with radial sound technology (rst), 80mj/10hz×2500 pulses per cheek and 1,000 pulses over the upper lip.Immediately after the first treatment, lasting 10 minutes, the patient stated that the nodules felt ¿less tight¿ and were ¿less hot and uncomfortable.¿ immediately post-procedure, the nodules felt smaller and softer on palpation.The patient agreed to return for three additional sessions over the next two weeks and to delay treatment with hyaluronidase or oral corticosteroids.After the fourth rst treatment, the nodules had resolved completely.This is the same event and the same patient reported under mdr id# 3005113652-2022-00185 (allergan complaint #(b)(4)).This mdr is being submitted for the second suspect product, juvéderm® volbella¿ xc.
 
Manufacturer Narrative
Article citation: ostezan l, peck j."radial sound (shockwave) therapy resolves delayed-onset nodules following injection of hyaluronic acid dermal filler: a case study." j clin aesthet dermatol.2021;14(12 suppl 1):s15¿s17.Pmid: 35291262; pmcid: pmc8903222.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.The event of inflammatory nodule is a known potential adverse event addressed in the product labeling.The event of upper respiratory infection, deemed not device related is considered an unexpected adverse drug experience.
 
Event Description
Additionally, the healthcare professional reported injecting the patient with 3 ml of juvéderm voluma® xc and 2 ml of juvéderm® volbella¿ xc.The event "migrated bilaterally to the lower face." the patient was also treated with 800mg of ibuprofen twice a day and the radial sound technology (rst) treatments were a week apart.The event resolved the day of the fourth treatment.
 
Manufacturer Narrative
Clarification to h6: the filler was injected into the patient and is not accessible for return.The syringe was discarded.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.
 
Manufacturer Narrative
A review of the device history record has been completed.No deviations or non-conformance's noted.
 
Event Description
Healthcare professional reported in the article ¿radial sound (shockwave) therapy resolves delayed-onset nodules following injection of hyaluronic acid dermal filler: a case study¿ that a patient was injected in the cheeks and midface with juvéderm® voluma¿ xc and in the perioral rhytids with juvéderm® volbella¿ xc.Three months later, the patient experienced ¿five circumoral nodules¿ bilaterally in the oral commissures that were not visible but could be detected by palpation.The patient reported that the nodules felt ¿hot and tight¿ under the skin.The patient also reported to have experienced a non-device related ¿upper respiratory infection¿ two weeks before the nodules appeared, but was afebrile upon presentation, with no systemic signs of infection; thus, an infectious etiology was not suspected regarding the nodules.The patient was treated with radial sound technology (rst), 80mj/10hz×2500 pulses per cheek and 1,000 pulses over the upper lip.Immediately after the first treatment, lasting 10 minutes, the patient stated that the nodules felt ¿less tight¿ and were ¿less hot and uncomfortable.¿ immediately post-procedure, the nodules felt smaller and softer on palpation.The patient agreed to return for three additional sessions over the next two weeks and to delay treatment with hyaluronidase or oral corticosteroids.After the fourth rst treatment, the nodules had resolved completely.This is the same event and the same patient reported under mdr id# 3005113652-2022-00185 (allergan complaint #(b)(4).This mdr is being submitted for the second suspect product, juvéderm® volbella¿ xc.
 
Search Alerts/Recalls

  New Search  |  Submit an Adverse Event Report

Brand Name
VOLBELLA WITH LIDOCAINE
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
chris sprague
12331-a riata trace parkway
building 3
austin, TX 78727
8479375615
MDR Report Key13955688
MDR Text Key291381318
Report Number3005113652-2022-00186
Device Sequence Number1
Product Code LMH
UDI-Device Identifier10888628032460
UDI-Public10888628032460
Combination Product (y/n)Y
Reporter Country CodeUS
PMA/PMN Number
P110033
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Literature,Health Professional,Company Representative
Reporter Occupation Nurse Practitioner
Type of Report Initial,Followup,Followup
Report Date 05/02/2022
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 Expiration Date01/22/2019
Device Model Number95834 
Device Catalogue Number95834
Device Lot NumberV15LA70100
Was Device Available for Evaluation? No
Initial Date Manufacturer Received 03/22/2022
Initial Date FDA Received03/30/2022
Supplement Dates Manufacturer Received04/11/2022
04/27/2022
Supplement Dates FDA Received04/20/2022
05/04/2022
Was Device Evaluated by Manufacturer? Device Not Returned to Manufacturer
Date Device Manufactured02/22/2017
Is the Device Single Use? No
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Initial
Patient Sequence Number1
Treatment
JUVÉDERM® VOLUMA¿ XC
Patient Outcome(s) Required Intervention;
Patient Age75 YR
Patient SexFemale
-
-