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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 SRM-330
Medical Device Problem Code Device Appears to Trigger Rejection (1524)
Health Effect - Clinical Code Capsular Contracture (1761)
Date of Event 01/10/2023
Type of Reportable Event Serious Injury
Additional Manufacturer Narrative
The event of capsular contracture is a physiological complication and analysis of the device generally does not assist abbvie in determining a probable cause for this event no contact information was provided for the initial reporter, therefore additional event, product, and/or patient details are not attainable.Reason for reoperation: capsular contracture, baker grade iii.
 
Event or Problem Description
Healthcare professional reported via the national breast implant registry (nbir) manufacturer registry specific data report (mrsdr) "capsular contracture baker grade iii".This record is for the right side.Device was explanted.
 
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Brand Name
INSPIRA SMOOTH SILICONE GEL FILLED BREAST IMPLANT
Common Device Name
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
2525 dupont drive
irvine, CA 92612
8479366324
MDR Report Key24860920
Report Number9617229-2026-06655
Device Sequence Number13079190
Product Code FTR
UDI-Device Identifier10888628007093
UDI-Public(01)10888628007093
Combination Product (Y/N)N
Initial Reporter CountryUS
PMA/510(K) Number
P020056
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source Other
Initial Reporter Occupation Non-Healthcare Professional
Type of Report Initial
Report Date (Section B) 04/13/2026
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? No
Operator of Device Health Professional
Device Catalogue NumberSRM-330
Was Device Available for Evaluation? No
Type of Report(Section G)Initial
Initial Date Received by Manufacturer 01/18/2024
Initial Report FDA Received Date04/13/2026
Is the Device Labeled for Single Use? (Y/N) Yes
Is This a Single-Use Device that was
Reprocessed and Reused on a Patient? (Y/N)
No
Usage of Device Initial
Patient Sequence Number1
Outcome Attributed to Adverse Event Required Intervention;
Patient SexFemale
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