NATRELLE INSPIRA MODPROF 310CC SIZER US MSZ-M310

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a company representative,health report with the FDA on 2017-07-17 for NATRELLE INSPIRA MODPROF 310CC SIZER US MSZ-M310 manufactured by Allergan (costa Rica).

Event Text Entries

[80277002] Further information from the reporter regarding event, product, or patient details has been requested. No additional information is available at this time. Device labeling addresses the reported event as follows: each sizer is supplied sterile in a sealed, double package. Sterility of the sizer is maintained only if the packages, including the package seals, are intact. Do not use the product if the packages or seals have been damaged. Do not use damaged or contaminated re-sterilizable sizers.
Patient Sequence No: 1, Text Type: N, H10


[80277003] Company representative reported the doctor opened a resterilizable sizer and noticed the device "had particles like grit all over it". The device was washed and used.
Patient Sequence No: 1, Text Type: D, B5


[108013318] A review of the device history record has been completed. No deviations or non-conformances noted. Lab analysis results: visual analysis of the returned device identified: no unusual conditions and no particles as described in the original report. Visual analysis also identified weight to the spec and bubbles observed in the gel after the autoclave disinfection cycle. Additional analysis was performed and no particulates were observed. A microscopic analysis was performed which identified the device to be intact and functional. Based on the device analysis the final assessment is: no issues found related with the manufacturing process and no particles on the device were observed. The device was found to be intact and functional.
Patient Sequence No: 1, Text Type: N, H10


[108013319] Company representative reported the doctor opened a resterilizable sizer and noticed the device "had particles like grit all over it". The device was washed and used.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number9617229-2017-00207
MDR Report Key6718050
Report SourceCOMPANY REPRESENTATIVE,HEALTH
Date Received2017-07-17
Date of Report2017-08-23
Date of Event2017-06-20
Date Mfgr Received2017-07-27
Device Manufacturer Date2017-03-14
Date Added to Maude2017-07-17
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer ContactMS. SUZANNE WOJCIK
Manufacturer Street301 W HOWARD LANE SUITE 100
Manufacturer CityAUSTIN TX 78753
Manufacturer CountryUS
Manufacturer Postal78753
Manufacturer Phone7372473605
Manufacturer G1ALLERGAN (COSTA RICA)
Manufacturer Street900 PARKWAY GLOBAL PARK ZONA FRANCA
Manufacturer CountryCS
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameNATRELLE INSPIRA MODPROF 310CC SIZER US
Generic NameSIZER, MAMMARY, BREAST IMPLANT VOLUME
Product CodeMRD
Date Received2017-07-17
Returned To Mfg2017-07-27
Catalog NumberMSZ-M310
Lot Number3033263
OperatorHEALTH PROFESSIONAL
Device AvailabilityR
Device AgeDA
Device Eval'ed by MfgrY
Device Sequence No1
Device Event Key0
ManufacturerALLERGAN (COSTA RICA)
Manufacturer Address900 PARKWAY GLOBAL PARK ZONA FRANCA CS


Patients

Patient NumberTreatmentOutcomeDate
101. Other 2017-07-17

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