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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ALLERGAN (PRINGY) JUVEDERM (VOLUME/CONCENTRATION/ADDITIVE UNKNOWN) IMPLANT, DERMAL, FOR AESTHETIC USE

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ALLERGAN (PRINGY) JUVEDERM (VOLUME/CONCENTRATION/ADDITIVE UNKNOWN) IMPLANT, DERMAL, FOR AESTHETIC USE Back to Search Results
Catalog Number UNK JUVEDERM-CONC/ADD
Device Problem Adverse Event Without Identified Device or Use Problem (2993)
Patient Problems Hypersensitivity/Allergic reaction (1907); Inflammation (1932); Skin Inflammation (2443)
Event Date 11/02/2017
Event Type  Injury  
Manufacturer Narrative
(b)(4). Further information from the reporter regarding event, product, or patient details has been requested. No additional information is available at this time. The events of hot, allergic reaction, swollen, welts, blisters, and cold sore are physiological complications and analysis of the device generally does not assist allergan in determining a probable cause for these events. Device labeling: contraindications: ¿ juvéderm® ultra xc is contraindicated for patients with severe allergies manifested by a history of anaphylaxis or history or presence of multiple severe allergies. Warnings: ¿ product use at specific sites in which an active inflammatory process (skin eruptions such as cysts, pimples, rashes, or hives) or infection is present should be deferred until the underlying process has been controlled. ¿ injection site reactions consist mainly of short-term inflammatory symptoms starting early after treatment and lasting
=
7 days in facial wrinkles and folds, and typically last
=
14 days in the lips. Refer to the adverse events section for details. Adverse events: ¿ the most common injection site responses for juvéderm® ultra xc were redness, swelling, tenderness, firmness, lumps/ bumps, discoloration, and bruising. Postmarket surveillance: the following adverse events were received from postmarket surveillance for juvéderm® ultra and ultra plus, with and without lidocaine, with a frequency of 5 events or more and were not observed in the clinical study; this includes reports received globally from all sources including scientific journals and voluntary reports. All adverse events obtained through postmarket surveillance are listed in order of number of reports received: lack or loss of correction, inflammatory reaction, allergic reaction, infection, migration, paresthesia, vascular occlusion, necrosis, abscess, flu-like symptoms, headache, malaise, vision abnormalities, scarring, nausea, drainage, dyspnea, beading, syncope, dizziness, anxiety, deeper wrinkle, and granuloma.
 
Event Description
Patient reported they were injected with unspecified juvéderm® and juvéderm voluma® xc. Patient was injected in the lips, cheeks and nasolabial folds but was unsure of where each product was injected. After injection patient stated ¿my face immediately got really hot, i feel like i'm having an allergic reaction, my upper lip is swollen, top of my mouth is swollen and has welts, i have blisters over the top lip and the symptoms started after i developed a cold sore on my chin. ¿ symptoms started the same day as the injection and progressed over time. Patient went to the emergency room three times and while there they were treated with an iv of pepcid, an iv of steroids, and were given two steroid shots. Patient was also prescribed oral steroids as well but decided not to take them because they are allergic to steroids. Patient stated they informed the emergency room of their allergy to steroids but was still given the iv and shots of steroids. Symptoms are ongoing. This is the same event and the same patient reported under mdr id# 3005113652-2017-01620 (allergan complaint #(b)(4)). This is the first mdr submitted for the first suspect product, unspecified juvéderm®.
 
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Brand NameJUVEDERM (VOLUME/CONCENTRATION/ADDITIVE UNKNOWN)
Type of DeviceIMPLANT, DERMAL, FOR AESTHETIC USE
Manufacturer (Section D)
ALLERGAN (PRINGY)
route de promery
zone artisanale de pre-mairy
pringy 74370
FR 74370
Manufacturer (Section G)
ALLERGAN (PRINGY)
route de promery
zone artisanale de pre-mairy
pringy 74370
FR 74370
Manufacturer Contact
suzanne wojcik
301 w howard lane
suite 100
austin, TX 78753
7372473605
MDR Report Key7106233
MDR Text Key94480274
Report Number3005113652-2017-01619
Device Sequence Number1
Product Code LMH
Combination Product (y/n)N
PMA/PMN Number
P050047
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type consumer
Type of Report Initial
Report Date 12/11/2017
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received12/11/2017
Is this an Adverse Event Report? Yes
Is this a Product Problem Report? No
Device Operator
Device Catalogue NumberUNK JUVEDERM-CONC/ADD
Was Device Available for Evaluation? No
Was the Report Sent to FDA?
Event Location No Information
Date Manufacturer Received11/15/2017
Was Device Evaluated by Manufacturer? Device Not Returned to Manufacturer
Is the Device Single Use? Yes
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage

Patient Treatment Data
Date Received: 12/11/2017 Patient Sequence Number: 1
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