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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: TAMBRANDS MANUFACTURING, INC TAMPAXTAMPONSPEARLFULLSIZEULTRAUNSCNT45CT; TAMPON, MENSTRUAL, UNSCENTED - HEB

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TAMBRANDS MANUFACTURING, INC TAMPAXTAMPONSPEARLFULLSIZEULTRAUNSCNT45CT; TAMPON, MENSTRUAL, UNSCENTED - HEB Back to Search Results
Lot Number 71227
Medical Device Problem Code Insufficient Device Problem Information (3190)
Health Effect - Clinical Codes Foreign Body In Patient (2687); Appropriate Clinical Signs, Symptoms and Conditions Term/Code Not Available (4581)
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
There is insufficient information to perform an investigation.
 
Event or Problem Description
Tampon stuck in my back end [foreign body in gastrointestinal tract].Tampon stuck in back end.Have colon issues.Was recommended to use this [intentional device use issue].Tampon stuck in back end - rectum [incorrect route of product administration].Case narrative: consumer reported via phone that the tampon got stuck in her back end.No serious injury was reported.
 
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Brand Name
TAMPAXTAMPONSPEARLFULLSIZEULTRAUNSCNT45CT
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 Key25066902
Report Number1219109-2026-00115
Device Sequence Number16054133
Product Code HEB
UDI-Device Identifier00073010714410
UDI-Public(01)00073010714410
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
Report Date (Section B) 05/04/2026
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 Number71227
Was Device Available for Evaluation? No
Type of Report(Section G)Initial
Initial Date Received by Manufacturer Not provided
Initial Report FDA Received Date05/04/2026
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)
No
Usage of Device Unknown
Patient Sequence Number1
Patient SexFemale
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