Incidents

Incident number: 106807 Date: 3. February 2026

Company / Customer * Contact person *

E-mail address * Article number *

Quantity * LOT-number / Serial number

Invoice number * Invoice date

Date of the incident

Detailed description (of defect) *

Did the fault cause an significant and relevant extension of the operation? *
YesNo

Has the patient, the user or a third party been seriously injured or dead? *
YesNo

Has the instrument been decontaminated? *
YesNo

Please attach pictures if available

I confirm that all instruments, devices and monitors are shipped in their original packaging to prevent damage. RZ Medizintechnik is not liable for damage caused by incorrect transport. *

I certify that the above instrument is free of harmful substances and has been decontaminated according to the sterilization instructions. The return form was completed completely and to the best of my conscience. *

I confirm and agree that RZ will destroy and dispose my returned products if they obviously are not cleaned and/or sterilized. A simple picture to proof this will be taken by our QC department. I understand that these are national guidelines and I have no right to ask RZ for any compensation.

Website

Email*

Privacy policy noted. *