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To the Editor.
—The Norplant system (Wyeth-Ayerst Laboratories, Philadelphia, Pa) was recently introduced in the United States. It consists of six Silastic capsules containing levonorgestrel that are surgically implanted under the skin of the medial upper arm with a trocar introducer and provide 5 years of contraception. The manufacturer has been training gynecologists and family physicians in the insertion technique through a combination of an audiovisual training kit, a dummy arm, and hands-on training sessions with live patients.I recently attended one of these training sessions and discovered a serious perception problem regarding the sterility of the system's packaging. The insertion kit has an outer cardboard box with an inner plastic tray that holds all of the sterile-wrapped insertion materials. This tray has the superficial appearance of a lumbar puncture or subclavian catheter insertion tray that most US physicians are familiar with. However, the Norplant packaging materials are simply packaging—they
Reynolds RD. Sterility of Norplant Packaging. JAMA. 1991;266(17):2373. doi:10.1001/jama.1991.03470170061018