REVANESSE LIPS+ (WITH LIDOCAINE) 1.2 ML
Received Apr 25, 2025 · Event occurred Mar 24, 2025
Report 3004423487-2025-00011 · MDR key 21911776
Device
Generic name
Revanesse Lips+ (with Lidocaine) 1.2 Ml
Manufacturer
Prollenium Medical Technologies Inc.Model number
PN40149Lot number
23I030
Product problems
- Adverse Event Without Identified Device or Use Problem
- Adverse Event Without Identified Device or Use Problem
Patient
NA · Female
- Nodule
- Nodule
Narrative
Description of Event or Problem
ADVERSE EVENT INFORMATION: THE INJECTOR REPORTS THAT PATIENT WAS INJECTED ON (B)(6) 2024 WITH REVANESSE LIPS+ WITH LIDOCAINE ON (B)(6) 2024 IN 0.5 ML CUPID'S BOW, RED VERMILLION TUBERCLE, UPPER AND LOWER LIPS. THE INJECTOR REPORTS THAT SHE OBSERVED ON (B)(6) 2024 THE PATIENT SHOWS TWO SMALL IMPROVING NODULES ARE PRESENT AT THE CORNERS OF THE MOUTH AND TWO ON THE UPPER LIP, CONTINUING TO DECREASE IN SIZE. THE NODULES AT THE MOUTH CORNERS ARE SEMI-HARD AND TENDER, WITH NO ERYTHEMA, SIGNS OF INFECTION, OR BIOFILM. NO FEVER IS PRESENT. MILD SWELLING IS NOTED, CONSISTENT WITH DELAYED-ONSET NODULES. THE PATIENT HAS COMPLETED THE SECOND COURSE OF PREDNISONE 60 MG TAPER AND A PROPHYLACTIC COURSE OF CIPROFLOXACIN 500 MG. OVER THE COURSE OF 9 VISITS FROM (B)(6) 2024 TO (B)(6) 2025, THE PATIENT UNDERWENT TREATMENT THAT INCLUDED INTRALESIONAL HYLENEX AND KENALOG-40 INJECTIONS, ORAL STEROID COURSES, AND ULTRASOUND IMAGING. PROLLENIUM HAS REACHED OUT TO THE INJECTOR/CLINIC MULTIPLE TIME TO OBTAIN MORE INFORMATION TO CONDUCT A THROUGH INVESTIGATION HOWEVER NO RESPONSE WAS PROVIDED.
Remedial action
- Patient Monitoring