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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-500
Medical Device Problem Codes Fluid/Blood Leak (1250); Device Appears to Trigger Rejection (1524)
Health Effect - Clinical Code Capsular Contracture (1761)
Date of Event 08/20/2026
Type of Reportable Event Serious Injury
Event or Problem Description
Healthcare professional reported "capsular contracture baker grade iv", "deflation".This record is for the left side.Device was explanted.
 
Additional Manufacturer Narrative
Continued e1 -- alternate email addresses: dr.Slinder@gmail.Com; addy90210@gmail.Com; 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.No contact information was provided for the initial reporter, therefore additional event, product, and/or patient details are not attainable.Reason for reoperation: deflation, capsular contracture baker grade iv.
 
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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 Key50762775
Report Number9617229-2026-17528
Device Sequence Number13071751
Product Code FWM
UDI-Device Identifier10888628000445
UDI-Public(01)10888628000445(17)Unknown
Combination Product (Y/N)N
Initial Reporter StateCA
Initial Reporter CountryUS
PMA/510(K) Number
P990074
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2014
Device Explanted Year2026
Reporter Type Manufacturer
Report Source Health Professional
Initial Reporter Occupation Physician
Type of Report Initial
Report Date (Section B) 09/14/2026
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-500
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Initial Date Received by Manufacturer 08/26/2026
Initial Report FDA Received Date09/14/2026
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 Age51 YR
Patient SexFemale
Patient Weight125 LB
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