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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 Codes Fluid/Blood Leak (1250); Device Appears to Trigger Rejection (1524)
Health Effect - Clinical Code Capsular Contracture (1761)
Date of Event 05/01/2026
Type of Reportable Event Serious Injury
Event or Problem Description
Healthcare professional reported "deflation".Later healthcare professional reported capsular contracture baker grade iv and "hole in radius (edge)".This record is for the right side.The device was explanted.
 
Additional Manufacturer Narrative
Device evaluation: the device related to the reported events deflation and capsular contracture was received on september 14, 2026 with catalog mcghan360cc.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: ¿ capsular contracture: unable to observe through visual inspection as it is a physiological phenomenon.¿ deflation: observed two openings 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: d.9., h.2., h.3., h.6.
 
Additional Manufacturer Narrative
A review of the device history record has been completed.No deviations or non-conformances noted.The event of capsular contracture is a physiological complication and analysis of the device generally does not assist allergan in determining a probable cause for this event.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 and capsular contracture, baker grade iv.
 
Event or Problem Description
Healthcare professional reported "deflation".Later healthcare professional reported capsular contracture baker grade iv and "hole in radius (edge)".This record is for the right side.The 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 Key50181910
Report Number9617229-2026-14909
Device Sequence Number18606751
Product Code FWM
UDI-Device Identifier10888628000230
UDI-Public(01)10888628000230(17)020427
Combination Product (Y/N)N
Initial Reporter StateTX
Initial Reporter CountryUS
PMA/510(K) Number
P990074
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year1999
Device Explanted Year2026
Reporter Type Manufacturer
Report Source Health Professional
Initial Reporter Occupation Physician
Type of Report Initial
Report Date (Section B) 08/07/2026
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 Date04/27/2002
Device Catalogue Number68-360
Device Lot Number535667
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Initial Date Received by Manufacturer 07/15/2026
Initial Report FDA Received Date08/07/2026
Date Device Manufactured11/19/1998
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 Age54 YR
Patient SexFemale
Patient Weight127 LB
Patient RaceWhite
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