Materiovigilance: Reporting of an incident or risk of an incident involving a medical device (Form 10246*05)

Ministry of Health - Cerfa n° 10246*05

Allows you to report an incident or risk of an incident with a medical device to the National Agency for Drug and Health Product Safety (ANSM). Alert Help Sheet depending on the severity of the incident.

Go to the online administrative form

Verified 19 March 2018 - Directorate for Legal and Administrative Information (Prime Minister)

J'ai réalisé une démarche administrative

Je donne mon avis sur Services Publics +. L'administration concernée me répondra.