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Medical Device Product Liability Case - Intake Form

Prescription medications can be dangerous if used or administered incorrectly. Your doctor is responsible for prescribing the right medication and your pharmacist is in charge of filling the prescription. If you have questions about defective prescription medication, contact our firm to schedule a consultation with an experienced defective medical products attorney for straightforward solutions that will work for you.

Law Firm Representing People Injured by Defective Drugs and Medical Devices

Help is available for people who have been injured and family members who have lost loved ones as a result of defective drugs and medical devices. Whether the injury or fatality was a result of Vioxx, breast implants or a pacemaker, a product liability case involving drugs or medical devices requires detailed investigation and research. James F. Humphreys & Associates, L.C., represents personal injury victims injured by defective drugs or medical devices.

Thank you for contacting James F. Humphreys & Associates, L.C. Your message has been sent.

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Drugs and Medical Devices Contact Form

*First Name

*Last Name

*Email Address

*Phone Number

*Zip

Street Address

Apt/Ste

Incident Street Address

Incident Apt/Ste

*Incident Zip

What is the name of the medical device you were using?

Who prescribed the device?

For what purpose or medical condition was it prescribed?

Was the device accomplishing that purpose?
Yes  No 

Who was monitoring your condition while you were using the device?

Where did you acquire the device?

Did anyone provide you with instructions regarding the device?
Yes  No 

Were you using the device properly when it caused you harm?
Yes  No 

How did the device injure you?

Was the device ever repaired? When and by whom? Describe the repair.

Was the device ever altered? When and by whom? Describe the alteration.

When did you first seek medical care for the injury caused by the device?

What is the current status of the injury caused by the device? Prognosis?

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Charleston

James F. Humphreys & Associates, L.C.
United Center, Suite 800
500 Virginia Street East
Charleston, WV 25301
Charleston Law Office