Brand Name | TROJAN ULTRA THIN LUBRICATED CONDOMS, 12 CT |
Type of Device | CONDOM, PRODUCT CODE: HIS |
Manufacturer (Section D) |
CHURCH & DWIGHT CO., INC. |
500 charles ewing boulevard |
ewing NJ 08628 |
|
Manufacturer (Section G) |
CHURCH & DWIGHT CO., INC. |
1851 touchstone drive |
|
south chesterfield VA 23834 |
|
Manufacturer Contact |
stacey
harshaw
|
469 north harrison street |
princeton, NJ 08543
|
6098067868
|
|
MDR Report Key | 8906107 |
MDR Text Key | 154732140 |
Report Number | 2280705-2019-00015 |
Device Sequence Number | 1 |
Product Code |
HIS
|
Combination Product (y/n) | N |
Number of Events Reported | 1 |
Summary Report (Y/N) | N |
Report Source |
Manufacturer
|
Source Type |
consumer |
Reporter Occupation |
Other
|
Type of Report
| Initial |
Report Date |
07/08/2019 |
1 Device was Involved in the Event |
|
1 Patient was Involved in the Event |
|
Is this an Adverse Event Report? |
Yes
|
Is this a Product Problem Report? |
No
|
Device Operator |
No Information
|
Was Device Available for Evaluation? |
No
|
Initial Date Manufacturer Received |
06/09/2019
|
Initial Date FDA Received | 08/19/2019 |
Was Device Evaluated by Manufacturer? |
No
|
Is the Device Single Use? |
Yes
|
Is This a Reprocessed and Reused Single-Use Device? |
No
|
Type of Device Usage |
N
|
Patient Sequence Number | 1 |
|
|