Get Canada Medical Device Problem Report Form For Health Care Professionals 2019-2025

Completing the Canada Medical Device Problem Report Form For Health Care Professionals is an essential step in reporting issues related to medical devices. This guide will help you navigate the form online with clarity and support.

Follow the steps to successfully complete the report form.

1. Click ‘Get Form’ button to obtain the form and open it in your PDF reader.
2. Begin by filling in the report and submitter information. This includes specifying whether it’s an initial or follow-up report, along with personal and organizational details such as names, contact information, and the date the report is submitted.
3. In the affected person section, identify the individual impacted by the incident. Include details such as the person’s height, weight, age, sex, and any consequences stemming from the incident.
4. Provide information about the device involved in the incident, including the device name, model, serial number, and any other relevant identifiers. You must fill out either the device name or device identifier.
5. Detail the incident information by providing the date, location, and a comprehensive description of what occurred.
6. In the actions taken section, describe any corrective measures that the hospital or manufacturer may have implemented following the incident.
7. If necessary, use the additional details section to include any further information regarding other affected persons or devices.
8. After completing all sections, ensure all required fields are filled and accurate. Save your changes, and if needed, print or share the form as per the submission requirements.

Start filling out the Canada Medical Device Problem Report Form online today.