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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: TAMBRANDS MANUFACTURING, INC TAMPAXTAMPONSPEARLFULLSIZEULTRAUNSCNT18CT; TAMPON, MENSTRUAL, UNSCENTED - HEB

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TAMBRANDS MANUFACTURING, INC TAMPAXTAMPONSPEARLFULLSIZEULTRAUNSCNT18CT; TAMPON, MENSTRUAL, UNSCENTED - HEB Back to Search Results
Lot Number 5354243011 43 07:17
Medical Device Problem Codes Adverse Event Without Identified Device or Use Problem (2993); Insufficient Device Problem Information (3190)
Health Effect - Clinical Code Foreign Body In Patient (2687)
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
Product investigation is in progress.
 
Event or Problem Description
Tampons broke open inside of me.Had to try and get the material from inside of me- vagina [foreign body in reproductive tract].Tampons broke open [device breakage].Case narrative: consumer reported via e-mail that the tampon broke open while inside of her.No serious injury reported.
 
Additional Manufacturer Narrative
No failure could be identified as a result of the investigation.
 
Event or Problem Description
Tampons broke open inside of me.Had to try and get the material from inside of me- vagina [foreign body in reproductive tract].Tampons broke open [device breakage].Case narrative: consumer reported via e-mail that the tampon broke open while inside of her.No serious injury reported.
 
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Brand Name
TAMPAXTAMPONSPEARLFULLSIZEULTRAUNSCNT18CT
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 Key24979155
Report Number1219109-2026-00105
Device Sequence Number10480074
Product Code HEB
UDI-Device Identifier00073010009868
UDI-Public(01)00073010009868
Combination Product (Y/N)Y
Initial Reporter CountryUS
PMA/510(K) Number
K081555
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)Unknown
Reporter Type Manufacturer
Report Source Consumer
Initial Reporter Occupation Other
Type of Report Initial,Followup
Report Date (Section B) 05/13/2026
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 Number5354243011 43 07:17
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? No
Type of Report(Section G)Follow-Up
Initial Date Received by Manufacturer Not provided
Supplement Date Received by ManufacturerNot provided
Initial Report FDA Received Date04/24/2026
Supplement Report FDA Received Date05/27/2026
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)
Yes
Usage of Device Initial
Patient Sequence Number1
Patient Age39 YR
Patient SexFemale
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