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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 68HP-320
Medical Device Problem Code Fluid/Blood Leak (1250)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 05/01/2026
Type of Reportable Event Serious Injury
Additional Manufacturer Narrative
Clarification for b3: this is a partial date of event.Clarification for d6a: this is a partial date of implant.Additional, changed, and/or corrected data: d6b, d9, g2, h3, h6.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 unidentified (tear) 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 are found to be potentially related to the manufacturing process, and, therefore, no further actions are required for these observations.
 
Event or Problem Description
Patient reported "deflation/leak".Healthcare professional then confirmed "deflation".This record is for the right side.Device was explanted.
 
Additional Manufacturer Narrative
This report was impacted by emdr scheduled maintenance occurring (b)(6) 2026 a review of the device history record has been completed.No deviations or non-conformances noted.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
Patient reported "deflation/leak".Healthcare professional then confirmed "deflation".This record is for the right side.Device was explanted.
 
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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 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
+1(847)936-6324
MDR Report Key50031646
Report Number9617229-2026-14120
Device Sequence Number16057507
Product Code FWM
UDI-Device Identifier10888628000391
UDI-Public(01)10888628000391(17)100325
Combination Product (Y/N)N
Initial Reporter CountryUS
PMA/510(K) Number
P990074
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2006
Reporter Type Manufacturer
Report Source Consumer
Initial Reporter Occupation Non-Healthcare Professional
Type of Report Initial
Report Date (Section B) 07/26/2026
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 Expiration Date03/25/2010
Device Catalogue Number68HP-320
Device Lot Number1251989
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? No
Initial Date Received by Manufacturer 06/30/2026
Initial Report FDA Received Date07/27/2026
Date Device Manufactured04/26/2006
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 Age56 YR
Patient SexFemale
Patient Weight154 LB
Patient RaceWhite
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