Rachel Lietzke Payne started using NuvaRing in 2008, when she was a 20<year<old college student. The contraceptive device appealed to her because it was easy to use. Birth control pills have to be taken every day, but NuvaRing didn’t —and was said to be just as effective at preventing pregnancy.

One Monday in October of 2010, more than a year after she first began using the vaginal ring, Payne met her father for a standing lunch date at Buffalo Wild Wings in Casselberry, north of where they lived in Orlando. When she and her dad walked out of the restaurant, Payne suddenly fell ill and spat up quarter<size chunks of blood onto the cement.

Payne was rushed to the hospital, where she spent 10 days being pumped with anticoagulants to thin her blood. She was diagnosed as having developed a blood clot in her lung, a condition that could have been fatal. “It took them a while to figure out that it was blood clots, because I was 22 at the time,” said Payne, who is now a married 25<year<old aspiring air traffic controller with a toddler son. She was also a nonsmoker and fit, and she had no family history of blood clots, all potential risk factors.

But her doctors landed on what they believed might have caused the clotting: the NuvaRing.