MAUDE Adverse Event Report: TAMBRANDS MANUFACTURING, INC TAMPAXTAMPONSPEARLFULLSIZEREGNORUNSCNT96CT; TAMPON, MENSTRUAL, UNSCENTED - HEB

Lot Number 3164243046W

Device Problem No Apparent Adverse Event (3189)

Patient Problem No Clinical Signs, Symptoms or Conditions (4582)

Event Type  malfunction  

Manufacturer Narrative

Product investigation is in progress.

Event Description

String come apart from the tampon [device breakage].Case narrative: consumer reported via e-mail that the tampon string came apart inside her.No injury reported.

Manufacturer Narrative

Product investigation is in progress.

Event Description

String come apart from the tampon [device breakage].Case narrative: consumer reported via e-mail that the tampon string came apart inside her.No injury reported.

Manufacturer Narrative

No failure could be identified as a result of the investigation.

Event Description

String come apart from the tampon [device breakage].Case narrative: consumer reported via e-mail that the tampon string came apart inside her.No injury reported.

• Brand Name: TAMPAXTAMPONSPEARLFULLSIZEREGNORUNSCNT96CT
• Type of Device: TAMPON, MENSTRUAL, UNSCENTED - HEB
• Manufacturer (Section D): TAMBRANDS MANUFACTURING, INC; 2879 hotel rd; auburn 04210
• Manufacturer (Section G): TAMBRANDS MANUFACTURING, INC; 2879 hotel rd; auburn 04210
• Manufacturer Contact: manager affairs,feminine care ; winton hill business center b; 6280 center hill avenue; cincinnati 45224
• MDR Report Key: 17823656
• MDR Text Key: 324324016
• Report Number: 1219109-2023-00315
• Device Sequence Number: 1
• Product Code: HEB
• Combination Product (y/n): Y
• Reporter Country Code: US
• PMA/PMN Number: K081555
• Number of Events Reported: 1
• Summary Report (Y/N): N
• Report Source: Manufacturer
• Source Type: Consumer
• Reporter Occupation: Other
• Type of Report: Initial,Followup,Followup
• Report Date: 10/20/2023

1 Device was Involved in the Event

1 Patient was Involved in the Event

• Date FDA Received: 09/27/2023
• Is this an Adverse Event Report?: No
• Is this a Product Problem Report?: Yes
• Device Operator: Lay User/Patient
• Device Lot Number: 3164243046W
• Was Device Available for Evaluation?: Device Returned to Manufacturer
• Is the Reporter a Health Professional?: No
• Was Device Evaluated by Manufacturer?: Yes
• Is the Device Single Use?: Yes
• Is This a Reprocessed and Reused Single-Use Device?: No
• Type of Device Usage: Initial
• Patient Sequence Number: 1
• Patient Sex: Female