FDA Adverse Event Injury Summary report: N

PEARL

MDR report key: 490458 · Received August 20, 2003

Report

Report Number
MW4003581
Event Type
Injury
Date Received
August 20, 2003
Report Date
August 20, 2003
Manufacturer
TAMBRANDS, INC.
Product Code
HEB
Report Source
Voluntary report
Reporter Location
OH, US
Reporter Occupation
PATIENT FAMILY MEMBER OR FRIEND

Narratives

Description of Event or Problem · 1

PT WAS USING THE REFERENCED BRAND OF TAMPON AND WHEN THEY WERE DIAGNOSED AS HAVING TSS. PARENT STATED THAT THE PT BECAME ILL - 5 DAYS INTO CYCLE AND THAT THEY HAD BEEN USING ONLY THIS BRAND OF TAMPON. PARENT STATED THE PT STARTED USING THIS BRAND OF TAMPON 6 OR 7 MONTHS AGO AND THAT NORMALLY THEY USE ONLY TAMPONS DURING THE SUMMER BECAUSE OF THEIR SWIMMING ACTIVITIES. AT OTHER TIMES THEY MAY USE BOTH TAMPONS AND/OR PADS. PARENT STATED THAT THE PT BECAME ILL AFTER THE SUSPECT TAMPON HAD BEEN IN USE FOR - 7 HOURS AND THAT THE TAMPON WAS REMOVED BY THE HOSPITAL STAFF. PARENT ALSO STATED THAT THIS WAS NOT THE FIRST TAMPON USED FROM THE BOX.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 PEARL TAMPONS HEB TAMBRANDS, INC. * UNK

Patients

Seq Age Sex Outcome Treatment
1 * Hospitalization