U BY KOTEX CLICK : TAMPON, MENSTRUAL, UNSCENTED : HEB
Report
- Report Number
- 3011109575-2019-01272
- Event Type
- Injury
- Date Received
- May 29, 2019
- Date of Event
- May 1, 2019
- Report Date
- May 29, 2019
- Manufacturer
- K-C AFC MANUFACTURING, S. DE R.L. DE C.V
- Product Code
- HEB
- UDI-DI
- 00036000998405
- PMA / PMN Number
- K113036
- Adverse Event
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- ID, US
- Reporter Occupation
- 003
Narratives
REVIEW OF THE DEVICE HISTORY RECORD (DHR) AND SUPPORTING QUALITY RECORDS CONFIRMED NO ANOMALIES THAT MAY HAVE CAUSED OR CONTRIBUTED TO THE REPORTED ISSUE.
CONSUMER REPORTED THE TAMPONS BECAME UNCOMFORTABLE AND PAINFUL TO USE. VAGINAL PAIN PERSISTED WHEN TAMPON WAS REMOVED. SHE EXPERIENCED SWEATING, HOT FLASHES, INTERMITTENT BLEEDING/SPOTTING, CONSTANT VAGINAL PAIN FROM MILD TO SEVERE, PAIN WITH URINATION AND VAGINAL DISCHARGE. SYMPTOMS STARTED TWO YEARS AGO AND PROGRESSIVELY WORSENED EVEN AFTER SHE STOPPED TAMPON USE. SHE WENT TO HER PCP SEVERAL TIMES AND HAD TESTS DONE. SHE HAD AN ABNORMAL RESULT FROM PAP TEST WHICH RESULTED NON-CANCEROUS, A BIOPSY OF HER CERVIX AND A TRANS-VAGINAL ULTRASOUND WHICH WERE BOTH NORMAL. SHE WAS REFERRED TO AN OBGYN AND HAD EXPLORATORY LAPAROSCOPIC OUTPATIENT SURGERY. OBGYN FOUND ENDOMETRIOSIS, ADHESIONS, AND SCAR TISSUE. SHE HAD FEVER POST-SURGERY. PAIN MEDICATIONS WERE PRESCRIBED POST-SURGERY. SHE STILL HAD SWEATING AND HOT FLASHES BUT THEY HAD GOTTEN BETTER. SHE TOOK AZITHROMYCIN IN CASE THERE WAS AN INFECTION. ALL TESTS CAME BACK NORMAL.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 443304 | U BY KOTEX CLICK : TAMPON, MENSTRUAL, UNSCENTED : HEB | TAMPON, MENSTRUAL, UNSCENTED | HEB | K-C AFC MANUFACTURING, S. DE R.L. DE C.V | SUPER | NN821213B0006 | 00036000998405 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 39 YR | Other |