Market Surveillance

Questionnaire Market Vigilance

Purpose

This questionnaire is used as a customer survey and active market surveillance in the course of MDR 2017/745 EU. Your feedback helps to ensure and improve the safety and performance of our medical devices.

This survey is anonymous and does not collect any personal data.

Thanks for your support.

Fields marked with * are mandatory fields

Place of Use
Country*
Job title*
Department*
Facility*
Questions regarding the product
1. In which medically used rooms is the device deployed?*
Multiple selection with "Strg/Ctrl"
2. Which clinical indications lead you to using the device?*
Multiple selection with "Strg/Ctrl"
3. Do you use the device during surgical procedures?*
- Yes
- No
4. Did you already encounter any malfunctioning of the device?*
- Yes
- No
5. When would you decide against the use of the device?*
6. How would you rate the usability of the device? (best: 10)*
7. How would you rate the overall device? (best: 10)*
8. Additional comments or details you would like to share
Optional Data
Reference number (REF) and Serial number (SN) from the nameplate on the lamp head
REF 4500-
SN

Place of Use

Questions regarding the product

Optional Data