If you have experienced a reportable incident according to §71, 72, 73 MPDG or MPAMIV para. 1, including malfunctions, failures or changes in characteristics or performance or inappropriate labelling or instructions for use of
a medical device, which directly or indirectly led, could have led or could lead to the death or serious deterioration
of the health of a patient, a user or another person, please complete this form in full.
