Global

‡ In these countries please contact our distributor

All Other Complaints Form

Welcome to the New Zealand Smith & Nephew AWM complaints registry.

Please fill out all areas of the form and click on the submit button at the end.

Was Patient Involved?
Was this an Out-Of-Box failure?
Was the problem noted before, during or after the procedure?


Was the patient anethetised at the time?
Did the problem result in a patient injury/ harm/ hazard?
Was a backup device available?



Did any pieces break off inside the wound?



Was the piece removed?
Will the device or a sample be returned for evaluation?



Is the device under warranty?
Are there any supporting images, surgical reports etc? If yes, please send all to the RA/QA coordinator
Could anything else have caused the incident?

Was any treatment required because of the event?

What is the patient's skin type?



Has the patient had this type of reaction/ incident before?

Does the patient have allergies?

Were other medical products used at the same time the complaint product was used?

Gender*