MAUDE Adverse Event Report: TAMBRANDS MANUFACTURING, INC TAMPAXTAMPONSPEARLFULLSIZEREGNORUNSCNT50CT; TAMPON, MENSTRUAL, UNSCENTED - HEB

Lot Number	431924304170 20:12
Medical Device Problem Codes	Adverse Event Without Identified Device or Use Problem (2993); Insufficient Device Problem Information (3190)
Health Effect - Clinical Codes	Fever (1858); Foreign Body In Patient (2687)
Type of Reportable Event	Malfunction
Additional Manufacturer Narrative
Product investigation is in progress.
Event or Problem Description
Had to go to urgent care to have the tampon fished out of me- vagina [foreign body in reproductive tract].I think i have a fever [pyrexia].I had a tampon that i was trying to take out when the string ripped off.Having to go to urgent care to have the tampon fished out [complication of device removal].String ripped completely off- tampon [device breakage].Case narrative: consumer reported via e-mail that the tampon string ripped off during removal.No serious injury reported.
Event or Problem Description
Had to go to urgent care to have the tampon fished out of me- vagina [foreign body in reproductive tract] i think i have a fever [pyrexia] i had a tampon that i was trying to take out when the string ripped off.Having to go to urgent care to have the tampon fished out [complication of device removal] string ripped completely off- tampon [device breakage] case narrative: consumer reported via e-mail that the tampon string ripped off during removal.No serious injury reported.
Additional Manufacturer Narrative
No failure could be identified as a result of the investigation.

• Brand Name: TAMPAXTAMPONSPEARLFULLSIZEREGNORUNSCNT50CT
• Common Device Name: 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: 21276189
• Report Number: 1219109-2025-00028
• Device Sequence Number: 20945095
• Product Code: HEB
• UDI-Device Identifier: 00073010711358
• UDI-Public: (01)00073010711358
• Combination Product (Y/N): Y
• Initial Reporter Country: US
• PMA/510(K) Number: K081555
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Serviced by Third Party (Y/N): Unknown
• Reporter Type: Manufacturer
• Report Source: Health Professional
• Initial Reporter Occupation: Nurse
• Type of Report: Initial,Followup
• Report Date (Section B): 03/03/2025

1 Device was Involved in the Event

1 Patient was Involved in the Event

• Is this an Adverse Event Report?: Yes
• Is this a Product Problem Report?: Yes
• Operator of Device: Lay User/Patient
• Device Lot Number: 431924304170 20:12
• Was Device Available for Evaluation?: No
• Is the Reporter a Health Professional?: Yes
• Type of Report(Section G): Initial
• Initial Date Received by Manufacturer: Not provided
• Supplement Date Received by Manufacturer: Not provided
• Initial Report FDA Received Date: 01/30/2025
• Supplement Report FDA Received Date: 03/05/2025
• Was Device Evaluated by Manufacturer? (Y/N): Device Not Returned to Manufacturer
• Is the Device Labeled for Single Use? (Y/N): Yes
• Is This a Single-Use Device that was Reprocessed and Reused on a Patient? (Y/N): No
• Usage of Device: Initial
• Patient Sequence Number: 1
• Patient Age: 24 YR
• Patient Sex: Female