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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 SRX-580
Medical Device Problem Code Adverse Event Without Identified Device or Use Problem (2993)
Health Effect - Clinical Code Appropriate Clinical Signs, Symptoms and Conditions Term/Code Not Available (4581)
Date of Event 08/03/2023
Type of Reportable Event Serious Injury
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: visibility/palpability.
 
Event or Problem Description
Healthcare professional reported via the national breast implant registry (nbir) manufacturer registry specific data report (mrsdr) "wrinkling/rippling ".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 Key24928665
Report Number9617229-2026-07139
Device Sequence Number14791586
Product Code FTR
UDI-Device Identifier10888628007581
UDI-Public(01)10888628007581
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,Health Professional
Initial Reporter Occupation Physician
Type of Report Initial
Report Date (Section B) 04/20/2026
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
Operator of Device Health Professional
Device Catalogue NumberSRX-580
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Initial
Initial Date Received by Manufacturer 01/18/2024
Initial Report FDA Received Date04/20/2026
Was Device Evaluated by Manufacturer? (Y/N) No
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
Patient RaceWhite
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