REVANESSE VERSA+ (WITH LIDOCAINE) 1.0 ML
Received Mar 25, 2021
Report 3004423487-2021-00004 · MDR key 11570103
Device
Generic name
Revanesse Versa+
Manufacturer
Prollenium Medical Technologies IncModel number
PN40082Catalog number
PN40082
Lot number
20B037
Product problems
- Device Slipped
- Migration
Patient
Not reported
- Swelling/ Edema
- Swelling/ Edema
Narrative
Additional Manufacturer Narrative
THE CLINICAL COMPLAINT WAS ADEQUATELY INVESTIGATED. IT HAS BEEN CONFIRMED THAT NO PREVIOUS CLINICAL COMPLAINTS HAVE BEEN FOUND FOR THE PARTICULAR LOT NUMBER IN QUESTION. THE BATCH RECORD, QC TEST REPORTS, AND TRAINING OF STAFF WERE ANALYZED AND IT HAS BEEN DETERMINED THAT PRODUCT IS WITHIN REQUIRED SPECIFICATIONS AND MANUFACTURED ACCORDING TO THE APPROPRIATE PROCEDURES.
Description of Event or Problem
THE PATIENT INITIALLY REPORTED THE COMPLIANT TO THE MANUFACTURER. THE MANUFACTURE HAS REACHED OUT TO THE NURSE INJECTOR, WHO REPORTED THAT THE PATIENT WAS INJECTED WITH REVANESSE VERSA+ WITH 3-4ML MIDFACE, CHEEKS, TEAR TROUGHS, LIPS. THE NURSE REPORTS THE USE OF A TOPICAL ANAESTHETIC 23/7 LT PRIOR TO INJECTION. THE NURSE AND PATIENT HAS DETAILED THE FOLLOWING ADVERSE EVENTS OCCURRING IN (B)(6) 2020 PRODUCT SLIDING IN THE "CHEEK AND MID-FACE". INTERMITTENT AND NON UNIFORM SWELLING OF SPECIFIC AREAS OF THE LIPS PRIMARILY UPON WAKING. CASE WAS REVIEWED BY THE MEDICAL DIRECTOR WHO STATS THAT THE MIGRATION OF THE PRODUCT IS DUE TO INJECTION INTO A SUBOPTIMAL LOCATION OR SIGNIFICANT PRESSURE APPLIED TO THE AREA THRU RUBBING AND MASSAGING. LIP SWELLING IS MULTIFACTORIAL AND CAN BE CAUSED BY FOODS, DRUGS, TOPICALS AND EXCESS WATER OR SALT INTAKE, ESPECIALLY IF THERE IS ADDITIONAL HA IN THE LIP. THE MEDICAL DIRECTOR HAS EXPRESSED THAT HAVING REVIEWED THE IMAGES PROVIDED HE CANNOT SEE SIGNS OF NODULES, INFLAMMATORY REACTIONS, VASCULAR EVENTS, PRODUCT MIGRATION OR ALLERGIC REACTIONS. THEREFORE SEE NO CLINICAL OR PHOTOGRAPHIC EVIDENCE OF A PRODUCT ADVERSE EVENT.
Remedial action
- Patient Monitoring