INSPIRA TEXTURED SILICONE GEL FILLED BREAST IMPLANT N-TRM210

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a company representative,distri report with the FDA on 2020-03-31 for INSPIRA TEXTURED SILICONE GEL FILLED BREAST IMPLANT N-TRM210 manufactured by Allergan (costa Rica).

Event Text Entries

[186282831] Allergan did not submit this mdr within 30 days of becoming aware. Recent stimulated reporting related to 2011068-7/2/19-001-r has increased complaint and mdr volume. Allergan is implementing a plan to address the increased volumes. Device evaluation: visual and microscopic analysis of the returned device identified: fold creases, red particles on shell, curved opening and broken shell with striated edge on anterior side, linear sharp opening in the same location of crease on posterior side, around 0-25% of the shell is missing, stress marks wear abrasion (on inner surface) and a weight test of the explanted material was verified and it was underweight. Based on the device analysis the final assessment is: a curved striated opening and broken shell assessed as surgical damage; a sharp crease opening assessed as fold flaw opening; missing shell that is assessed as inconclusive.
Patient Sequence No: 1, Text Type: N, H10


[186282832] Healthcare professional reported "capsular fibrosis / implant ruptured". The device was implanted beyond the expiration date. Device has been explanted. This record is for the right side.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number9617229-2020-03040
MDR Report Key9907758
Report SourceCOMPANY REPRESENTATIVE,DISTRI
Date Received2020-03-31
Date of Report2020-03-31
Date of Event2019-10-31
Date Mfgr Received2019-11-12
Device Manufacturer Date2009-10-19
Date Added to Maude2020-03-31
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 ContactMRS. MICHELLE BURGESS
Manufacturer Street12331-A RIATA TRACE PARKWAY BUILDING 3
Manufacturer CityAUSTIN TX 78727
Manufacturer CountryUS
Manufacturer Postal78727
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 NameINSPIRA TEXTURED SILICONE GEL FILLED BREAST IMPLANT
Generic NamePROSTHESIS, BREAST, NONINFLATABLE, INTERNAL, SILICONE GEL-FILLED
Product CodeFTR
Date Received2020-03-31
Returned To Mfg2020-02-29
Catalog NumberN-TRM210
Lot Number1772923
Device Expiration Date2014-10-16
OperatorHEALTH PROFESSIONAL
Device AvailabilityR
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. Required No Informationntervention 2020-03-31

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