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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-240
Medical Device Problem Codes Fluid/Blood Leak (1250); Device Appears to Trigger Rejection (1524)
Health Effect - Clinical Codes Capsular Contracture (1761); No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 02/06/2026
Type of Reportable Event Serious Injury
Event or Problem Description
Patient reported ¿deflation, capsular contracture and pain¿.Healthcare professional later confirmed deflation.This record is for the right side.The device was explanted.
 
Event or Problem Description
Patient reported ¿deflation, capsular contracture and pain¿.Healthcare professional later confirmed deflation.Later, healthcare professional reported "hole on valve side" and "capsular contracture baker grade i".This record is for the right side.The device was explanted.
 
Additional Manufacturer Narrative
A review of the device history record has been completed.No deviations or non-conformances noted.The event of capsular contracture a physiological complication and analysis of the device generally does not assist abbvie 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: capsular contracture baker grade unknown, deflation.
 
Additional Manufacturer Narrative
Unreporting e2303 and a010102 as the capsular contracture is baker grade i.Additional, changed, and/or corrected data: a2, a5, a6, b3, b5, h6.
 
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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 Key50571020
Report Number9617229-2026-16740
Device Sequence Number9891676
Product Code FWM
UDI-Device Identifier10888628000377
UDI-Public(01)10888628000377(17)270507
Combination Product (Y/N)N
Initial Reporter CountryUS
PMA/510(K) Number
P990074
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2025
Device Explanted Year2026
Reporter Type Manufacturer
Report Source Consumer,Health Professional
Initial Reporter Occupation Non-Healthcare Professional
Type of Report Initial,Followup
Report Date (Section B) 09/17/2026
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 Number68HP-240
Device Lot Number1191574
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? No
Initial Date Received by Manufacturer 08/17/2026
Supplement Date Received by Manufacturer09/03/2026
Initial Report FDA Received Date09/02/2026
Supplement Report FDA Received Date09/17/2026
Date Device Manufactured06/07/2023
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 Age47 YR
Patient SexFemale
Patient Weight136 LB
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