Duragesic Patch Recall Information
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Home Page | Duragesic News | Fentanyl Pain Patch Information | FREE Case Review
 
 
FDA issues alert on all Fentanyl Pain Patches -
including Duragesic.
Time is limited. Begin your FREE Review Today. Fill out the form below or call us toll free at 1-866-242-0905
Contact Information
Fill out the following form or call 1-866-242-0905 24 hours a day, 7 days a week for a Free Case Review.
First Name*
Last Name
Home Phone* - -
Work Phone* - -
Cell Phone* - -
Email Address*
Retype Email Address*
Street Address:
City
State/Zip
Injured Person's Contact Information
The injured person is
First Name:
Last Name:
Home Phone: - -
Work Phone: - -
Cell Phone: - -
Email Address:
Street Address:
City:
State/Zip
Date of Birth
Sex Male  Female
 
Did you or your loved once suffer injury from using the Duragesic Pain Patch?
YesNo
 
What type of injury occurred?
 
When did the injury or death occur?
 
If death, what is listed as cause of death on death certificate?
 
When was the patch used?
 
Do you have proof of using the Duragesic Pain Patch?
 
Manufacturer of the Pain Patch
 
Was the Duragesic Pain Patch used one of the recalled lots?
 
If yes, what was the lot/control number?
Click here to find lot # on packaging
 
What was the dosage/patch strength used?
 
Do you or your loved one currently have an attorney helping you with your potential Duragesic Recall case?
 
Additional Comments or Questions:

 
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