FDA Adverse Event Malfunction Summary report: N

L.TAMPONSORGCOTTONCOMPAKREG+SUPERNONDO45CT

MDR report key: 13367347 · Received January 27, 2022

Report

Report Number
1219109-2022-00033
Event Type
Malfunction
Date Received
January 27, 2022
Report Date
December 30, 2021
Manufacturer
ONTEX HYGIENEARTIKEL GMBH
Product Code
HEB
PMA / PMN Number
K162746
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
US
Reporter Occupation
OTHER
Health Professional
N

Narratives

Additional Manufacturer Narrative · 0

THERE IS INSUFFICIENT INFORMATION TO PERFORM A PRODUCT INVESTIGATION.

Additional Manufacturer Narrative · 0

A PRODUCT INVESTIGATION IS IN PROGRESS.

Description of Event or Problem · 0

COTTON IS SEPARATING FROM TAMPON DURING REMOVAL- VAGINA [FOREIGN BODY IN REPRODUCTIVE TRACT]. COTTON IS SEPARATING FROM TAMPON [DEVICE BREAKAGE]. COTTON IS SEPARATING FROM TAMPON DURING REMOVAL, RETAINED [COMPLICATION OF DEVICE REMOVAL] CASE DESCRIPTION: CONSUMER REPORTED VIA E-MAIL THAT COTTON IS SEPARATING FROM THE TAMPON DURING REMOVAL. NO SERIOUS INJURY REPORTED.

Description of Event or Problem · 0

COTTON IS SEPARATING FROM TAMPON DURING REMOVAL- VAGINA [FOREIGN BODY IN REPRODUCTIVE TRACT]. COTTON IS SEPARATING FROM TAMPON [DEVICE BREAKAGE]. COTTON IS SEPARATING FROM TAMPON DURING REMOVAL, RETAINED [COMPLICATION OF DEVICE REMOVAL]. CASE DESCRIPTION: CONSUMER REPORTED VIA E-MAIL THAT COTTON IS SEPARATING FROM THE TAMPON DURING REMOVAL. NO SERIOUS INJURY REPORTED. FOLLOW-UP: 07-FEB-2021: RETURNED PRODUCT IDENTIFIED AS ONTEX L. PLEASE SEE REPORT 1216894-2022-00007 FOR THE REPORT REGARDING THE ONTEX L. PRODUCT THAT WAS NOT MANUFACTURED BY TAMBRANDS MANUFACTURING, INC. IN AUBURN, MAINE, USA.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
102072 L.TAMPONSORGCOTTONCOMPAKREG+SUPERNONDO45CT TAMPON, MENSTRUAL, UNSCENTED HEB ONTEX HYGIENEARTIKEL GMBH 0246D541121189

Patients

Seq Age Sex Outcome Treatment
1 Female