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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: Allergan (Costa Rica) Style 68 Saline Filled Breast Implant; prosthesis, breast, inflatable, internal, saline

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Allergan (Costa Rica) Style 68 Saline Filled Breast Implant; prosthesis, breast, inflatable, internal, saline Back to Search Results
Catalog Number 68-450
Medical Device Problem Code Fluid/Blood Leak (1250)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Type of Reportable Event Serious Injury
Event or Problem Description
Healthcare professional reported a "deflation".This record is for the left side.The device was explanted.
 
Additional Manufacturer Narrative
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: deflation.
 
Event or Problem Description
Healthcare professional reported a "deflation".This record is for the left side.The device was explanted.
 
Additional Manufacturer Narrative
This report was impacted by emdr scheduled maintenance occurring july 22-27, 2026.A review of the device history record has been completed.No deviations or non-conformances noted.Device evaluation: per the investigation procedure, the device is analyzed through visual inspection microscopic inspection if openings are observed and a weight verification.Per the analysis performed, the assessments of the complaints and any potential manufacturing issue are displayed along with any further actions required: deflation: observed an opening through microscopic inspection assessed as fold flaw opening.No further actions are required as it is not related to the manufacturing process.None of the other observations performed during the device analysis creases and wear abrasion are found to be potentially related to the manufacturing process, and, therefore, no further actions are required for these observations.Additional, changed, and/or corrected data: d1, d2a, d2b, d4, d9, g4, h3, h4, h6.
 
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Brand Name
Style 68 Saline Filled Breast Implant
Common Device Name
prosthesis, breast, inflatable, internal, saline
Manufacturer (Section D)
Allergan (Costa Rica)
900 parkway global park
zona franc
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
2525 dupont drive
irvine, CA 92612
+1(847)936-6324
MDR Report Key24776601
Report Number9617229-2026-06000
Device Sequence Number12278382
Product Code FWM
UDI-Device Identifier10888628000261
UDI-Public(01)10888628000261(17)160229
Combination Product (Y/N)N
Initial Reporter StateAL
Initial Reporter CountryUS
PMA/510(K) Number
P990074
Number of Events Summarized1
Summary Report (Y/N)N
Device Explanted Year2026
Reporter Type Manufacturer
Report Source Health Professional
Initial Reporter Occupation Physician
Type of Report Initial,Followup
Report Date (Section B) 07/27/2026
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? Yes
Device Expiration Date02/29/2016
Device Catalogue Number68-450
Device Lot Number2264456
Was Device Available for Evaluation? Yes
Date Returned to Manufacturer07/01/2026
Is the Reporter a Health Professional? Yes
Was the Report Sent to FDA? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 03/11/2026
Supplement Date Received by Manufacturer07/01/2026
Initial Report FDA Received Date04/03/2026
Supplement Report FDA Received Date07/27/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured03/30/2012
Is This a Single-Use Device that was
Reprocessed and Reused on a Patient? (Y/N)
No
Patient Sequence Number1
Outcome Attributed to Adverse Event Required Intervention;
Patient SexFemale
Patient Weight363 LB
Patient RaceWhite
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