FDA Adverse Event Injury Summary report: N

U BY KOTEX CLICK : TAMPON, MENSTRUAL, UNSCENTED : HEB

MDR report key: 8652028 · Received May 29, 2019

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

Additional Manufacturer Narrative · 1

REVIEW OF THE DEVICE HISTORY RECORD (DHR) AND SUPPORTING QUALITY RECORDS CONFIRMED NO ANOMALIES THAT MAY HAVE CAUSED OR CONTRIBUTED TO THE REPORTED ISSUE.

Description of Event or Problem · 1

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