FDA Adverse Event
Injury
Summary report: N
TROJAN BRAND, MAGNUM THIN SUB-BRAND
MDR report key: 1821541
·
Received August 27, 2010
Report
- Report Number
- 2280705-2010-00011
- Event Type
- Injury
- Date Received
- August 27, 2010
- Date of Event
- July 30, 2010
- Report Date
- August 27, 2010
- Manufacturer
- CHURCH & DWIGHT CO., INC.
- Product Code
- HIS
- PMA / PMN Number
- K874383
- Adverse Event
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- DC, US
- Reporter Occupation
- NOT APPLICABLE
Narratives
Additional Manufacturer Narrative · 1
CONCLUSIONS - FOR FURTHER EVALUATION, CHURCH & DWIGHT CO., INC. HAS REQUESTED THE FOLLOWING FROM THE USER: THE PRODUCT, ITS ORIGINAL PACKAGING, AND COMPLETION OF AN EVENT QUESTIONNAIRE. TO DATE, THE REQUESTED HAS NOT YET BEEN RETURNED.
Description of Event or Problem · 1
ON (B)(6)2010, A CONSUMER REPORTED BY PHONE THAT HE "HAD 4 CONDOMS BREAK" AND "DEVELOPED A CLEAR DISCHARGE AND BURNING DURING URINATION" AND IS ON HIS "4TH DIFFERENT TYPE OF ANTIBIOTIC, SYMPTOMS STARTED 4 DAYS AFTER LAST BREAKAGE" AND "ALL TEST SO FAR HAVE SOME BACK NEGATIVE."
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1 | TROJAN BRAND, MAGNUM THIN SUB-BRAND | MALE LATEX CONDOM, S884.5300 | HIS | CHURCH & DWIGHT CO., INC. | TT9355Z |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | Required Intervention |