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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 68-360
Medical Device Problem Code Fluid/Blood Leak (1250)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 07/02/2026
Type of Reportable Event Serious Injury
Event or Problem Description
Healthcare professional reported "deflation".Healthcare professional later reported "any creases, any creases associated with hole and hole in radius (edge)".This record is for the left side.Device was explanted.
 
Event or Problem Description
Healthcare professional reported "deflation".Healthcare professional later reported "any creases, any creases associated with hole and hole in radius (edge)".This record is for the left side.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.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.
 
Additional Manufacturer Narrative
Additional, changed, and/or corrected: d9, h3 and h6.Continued e1: alternate email address: (b)(6).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 two openings through microscopic inspection 1 opening assessed as surgical damage and 1 opening assessed as fold flaw opening.No further actions are required as it is not related to the manufacturing process.¿ crease / folding of implant: observed creases on device through visual inspection.No further actions are required as it is not related to the manufacturing process.None of the other observations performed during the device analysis wear abrasion are found to be potentially related to the manufacturing process, and, therefore, no further actions are required for these observations.
 
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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 Key50069650
Report Number9617229-2026-14212
Device Sequence Number21384081
Product Code FWM
UDI-Device Identifier10888628000230
UDI-Public(01)10888628000230(17)090920
Combination Product (Y/N)N
Initial Reporter StateND
Initial Reporter CountryUS
PMA/510(K) Number
P990074
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2006
Device Explanted Year2026
Reporter Type Manufacturer
Report Source Health Professional
Initial Reporter Occupation Physician
Type of Report Initial
Report Date (Section B) 07/29/2026
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 Date09/20/2009
Device Catalogue Number68-360
Device Lot Number1155818
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Initial Date Received by Manufacturer 07/02/2026
Initial Report FDA Received Date07/29/2026
Date Device Manufactured10/26/2005
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 Age58 YR
Patient SexFemale
Patient RaceWhite
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