Underreporting and Data Blind Spots — The Risk You Can’t See
One of the most misunderstood features of tattoo adverse events is how often they never enter official systems. A manufacturer might assume, “If it were serious, we’d hear about it.” In practice, that assumption is unreliable.
There are three layers manufacturers should understand: reported events, underreported events, and data blind spots.
Reported Events
These are the cases that reach clinicians, regulators, insurers, or formal complaint channels. They are important—but they are not the majority.
Underreported Events
Many complications are managed informally. Artists may advise aftercare adjustments, suggest topical treatments, or recommend watchful waiting. Clients may avoid physicians due to cost, fear of judgment, or uncertainty about whether a reaction is “normal.” Social media threads often become the first place events are discussed—without structured data, without product batch tracking, and without medical confirmation.
Data Blind Spots
Even when an issue is reported, the system often fails to link key information:
product name vs. manufacturer vs. distributor
batch number
date of use
aftercare products and exposures
client medical history and known allergies
cross-use of cosmetic and tattoo lines
storage and handling conditions
This creates a dangerous situation for manufacturers. Incomplete data doesn’t protect you. It increases the chance that a single event will be generalized into a broad narrative about your product category.
The solution is not to blame artists or clients for underreporting. The solution is to build surveillance models that are realistic: clear definitions, simple reporting tools, strong privacy protections, and manufacturer-facing investigation frameworks that do not require clinical infrastructure.
TIMA supports shared adverse event models because surveillance is becoming a defining expectation of responsible manufacturing. If manufacturers do not help build it, they will be forced to comply with systems that don’t fit how body art actually operates.