FDA Adverse Event Injury Summary report: N

DEPEND UNDERGARMENTS : GARMENT, PROTECTIVE, FOR INCONTINENCE : EYQ

MDR report key: 8713400 · Received June 19, 2019

Report

Report Number
9615625-2019-00001
Event Type
Injury
Date Received
June 19, 2019
Date of Event
March 5, 2019
Report Date
June 19, 2019
Manufacturer
KIMBERLY-CLARK PERSONAL HYGIENIC PRODUCTS CO. ,LTD
Product Code
EYQ
PMA / PMN Number
EXEMPT
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
003

Narratives

Additional Manufacturer Narrative · 1

A MANUFACTURER LOT CODE WAS NOT PROVIDED. WITH NO MEANS TO ASCERTAIN THE MANUFACTURER/ASSET LINE AND DAY OF PRODUCTION, NO FURTHER INVESTIGATION ON DOCUMENTS AND SUPPORTING RECORDS CAN BE PERFORMED.

Description of Event or Problem · 1

CONSUMER REPORTED HE EXPERIENCED A BURNING, PAINFUL IRRITATION IN THE GROIN AREA AND WAS USING CREAM AND TOILET PAPER AS A BARRIER WHILE WEARING THE PADS. HE HAD BLOOD IN HIS URINE AFTER WEARING A PAD FOR THREE DAYS. HE WAS DIAGNOSED WITH A URINARY TRACT INFECTION AND HOSPITALIZED FOR ONE DAY. WHILE IN THE HOSPITAL HE WAS ADMINISTERED IV ANTIBIOTICS AND GIVEN 850MG PILLS THAT HE TOOK FOR TWO WEEKS. HE NO LONGER HAD BLOOD IN HIS URINE AND HIS SYMPTOMS HAD IMPROVED. HE STOPPED USING THE PADS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
504514 DEPEND UNDERGARMENTS : GARMENT, PROTECTIVE, FOR INCONTINENCE : EYQ GARMENT, PROTECTIVE, FOR INCONTINENCE EYQ KIMBERLY-CLARK PERSONAL HYGIENIC PRODUCTS CO. ,LTD INCONTINENCE SHIELDS FOR MEN, LIGHT ABSORBENCY

Patients

Seq Age Sex Outcome Treatment
1 87 YR Hospitalization