Claim ANGIOLINE constantly carries out activities to improve quality and reliability of the manufactured products. In case of any events related to the use of our products, please provide full details in this form and send it to us. Use one form per each event. Standard period for consideration of the submitted event information is one month of the date of receipt of the device and all the required data as provided below. Medical institution details Data on medical devices Denomination Code number Lot (batch) number* Quantity Sent for analysis (if YES, tick off) * This is the required field. For the analysis to be performed, the following records have been sent: (if YES, tick off) Video of angiography Surgery protocol The form is submitted For information purposes Response is required Description of the event (this is the required field, unless the surgery protocol is submitted) Please indicate the date and provide a description of the event and its consequences.
