BEUDAMED
    FDA Adverse Event Injury Summary report: N

    DUREX EXTRA SENSITIVE LATEX

    MDR report key: 2142479 · Received June 22, 2011

    Report

    Report Number
    MW5021123
    Event Type
    Injury
    Date Received
    June 22, 2011
    Date of Event
    May 28, 2011
    Report Date
    June 22, 2011
    Manufacturer
    DUREX NORCROSS
    Product Code
    HIS
    Report Source
    Voluntary report
    Reporter Location
    WY, US
    Reporter Occupation
    PATIENT

    Narratives

    Description of Event or Problem · 1

    METAL WASHER WAS LOCATED INSIDE FOIL WRAPPER OF CONDOM. REASON FOR USE: BIRTH CONTROL, STD/STI PREVENTION.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 DUREX EXTRA SENSITIVE LATEX LATEX CONDOM HIS DUREX NORCROSS EXTRA SENSITIVE VT1006

    Patients

    Seq Age Sex Outcome Treatment
    1 29 YR Disability