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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-255
Medical Device Problem Code Device Appears to Trigger Rejection (1524)
Health Effect - Clinical Code Capsular Contracture (1761)
Type of Reportable Event Serious Injury
Event or Problem Description
Patient reported ¿capsular contracture baker grade iv; contracting; pain; coming out of the side toward my armpit; unable to lie on my stomach due to extreme pain; feeling like a hard ball and like a rock; severe hardness; lateral pocket slip; and projecting high like a headlight." healthcare professional later reported "capsular contracture baker grade iv." this record is for the right side.The device remains implanted.
 
Event or Problem Description
The device has been 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" 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: capsular contracture, baker grade iv.
 
Additional Manufacturer Narrative
Additional/corrected data: b2, b5, h6.
 
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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
+1(847)936-6324
MDR Report Key50667088
Report Number9617229-2026-17038
Device Sequence Number21370609
Product Code FTR
UDI-Device Identifier10888628007451
UDI-Public(01)10888628007451(17)290528
Combination Product (Y/N)N
Initial Reporter CountryUS
PMA/510(K) Number
P020056
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2025
Reporter Type Manufacturer
Report Source Consumer,Health Professional
Initial Reporter Occupation Non-Healthcare Professional
Type of Report Initial
Report Date (Section B) 09/08/2026
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? No
Operator of Device Health Professional
Device Catalogue NumberSRX-255
Device Lot Number1251435
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? No
Initial Date Received by Manufacturer 08/19/2026
Initial Report FDA Received Date09/08/2026
Date Device Manufactured06/28/2024
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 Other; Required Intervention;
Patient SexFemale
Patient Weight129 LB
Patient RaceWhite
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