Suggestion - G-Flex

Subject

Complaint details:

Description of the problem occurred *:

What were the consequences for the patient due to the adverse event? *

What has been done by the end user (i.e. Doctor, nurse, etc) to solve the the problem? *

Patient information (the case): gender, age, known medical history & clinical condition

Please note that any photos and/or videos that would help in the investigation of the root cause will stil be highly appreciated.

* Mandatory fields