{"id":3403,"date":"2020-11-27T23:46:25","date_gmt":"2020-11-27T22:46:25","guid":{"rendered":"https:\/\/www.ceatec.de\/?post_type=avada_portfolio&#038;p=3403"},"modified":"2020-12-11T11:54:36","modified_gmt":"2020-12-11T10:54:36","slug":"notification-form-for-incidents","status":"publish","type":"avada_portfolio","link":"https:\/\/www.ceatec.de\/en\/portfolio-items\/notification-form-for-incidents\/","title":{"rendered":"Notification Form for incidents"},"content":{"rendered":"<div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-1 fusion-flex-container nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-flex-start fusion-flex-content-wrap\" style=\"max-width:1144px;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-0 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-title title fusion-title-1 fusion-title-text fusion-title-size-one\" style=\"--awb-margin-top-small:0px;--awb-margin-right-small:0px;--awb-margin-bottom-small:20px;--awb-margin-left-small:0px;\"><div class=\"title-sep-container title-sep-container-left fusion-no-large-visibility fusion-no-medium-visibility fusion-no-small-visibility\"><div class=\"title-sep sep-double sep-solid\" style=\"border-color:#e0dede;\"><\/div><\/div><span class=\"awb-title-spacer fusion-no-large-visibility fusion-no-medium-visibility fusion-no-small-visibility\"><\/span><h1 class=\"fusion-title-heading title-heading-left fusion-responsive-typography-calculated\" style=\"margin:0;--fontSize:34;line-height:1.4;\">Notification Form for incidents<\/h1><span class=\"awb-title-spacer\"><\/span><div class=\"title-sep-container title-sep-container-right\"><div class=\"title-sep sep-double sep-solid\" style=\"border-color:#e0dede;\"><\/div><\/div><\/div><div class=\"fusion-text fusion-text-1\"><p>If you experience a <strong>reportable incident<\/strong> (1), you have to fill out this online form. Messages through another delivery path will not be accepted. Your report will be edited as soon as possible.<\/p>\n<\/div>\n<div class=\"wpcf7 no-js\" id=\"wpcf7-f1970-o1\" lang=\"en-US\" dir=\"ltr\" data-wpcf7-id=\"1970\">\n<div class=\"screen-reader-response\"><p role=\"status\" aria-live=\"polite\" aria-atomic=\"true\"><\/p> <ul><\/ul><\/div>\n<form action=\"\/en\/wp-json\/wp\/v2\/avada_portfolio\/3403#wpcf7-f1970-o1\" method=\"post\" class=\"wpcf7-form init\" aria-label=\"Contact form\" novalidate=\"novalidate\" data-status=\"init\">\n<fieldset class=\"hidden-fields-container\"><input type=\"hidden\" name=\"_wpcf7\" value=\"1970\" \/><input type=\"hidden\" name=\"_wpcf7_version\" value=\"6.1.5\" \/><input type=\"hidden\" name=\"_wpcf7_locale\" value=\"en_US\" \/><input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f1970-o1\" \/><input type=\"hidden\" name=\"_wpcf7_container_post\" value=\"0\" \/><input type=\"hidden\" name=\"_wpcf7_posted_data_hash\" value=\"\" \/>\n<\/fieldset>\n<div class=\"box\">\n\t<h3>Reporter Data\n\t<\/h3>\n\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"firma\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Company\/Hospital*\" value=\"\" type=\"text\" name=\"firma\" \/><\/span>\n\t<\/p>\n\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"full-name\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Person to contact*\" value=\"\" type=\"text\" name=\"full-name\" \/><\/span>\n\t<\/p>\n\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"str\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Street, No.*\" value=\"\" type=\"text\" name=\"str\" \/><\/span>\n\t<\/p>\n\t<p>[text* ort placeholder \"Zip, City*]\n\t<\/p>\n\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"land\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Country*\" value=\"\" type=\"text\" name=\"land\" \/><\/span>\n\t<\/p>\n\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"tel\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Phone No.*\" value=\"\" type=\"text\" name=\"tel\" \/><\/span>\n\t<\/p>\n\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"your-email\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-email wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-email\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"E-Mail*\" value=\"\" type=\"email\" name=\"your-email\" \/><\/span>\n\t<\/p>\n<\/div>\n<div class=\"box\">\n\t<h2>Incident\n\t<\/h2>\n\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"datum\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Date of incident*\" value=\"\" type=\"text\" name=\"datum\" \/><\/span>\n\t<\/p>\n\t<p>[text* ort2 placeholder \"Place of incident*]\n\t<\/p>\n\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"article\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Part No.*\" value=\"\" type=\"text\" name=\"article\" \/><\/span>\n\t<\/p>\n\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"charge\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Lot-\/Serial No*\" value=\"\" type=\"text\" name=\"charge\" \/><\/span>\n\t<\/p>\n\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"extra\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Equipment used with product*\" value=\"\" type=\"text\" name=\"extra\" \/><\/span>\n\t<\/p>\n\t<p>Description of incident*\n\t<\/p>\n\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"your-message\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" name=\"your-message\"><\/textarea><\/span>\n\t<\/p>\n\t<p>Injury to person(s)?* <span class=\"wpcf7-form-control-wrap\" data-name=\"schaden\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><label><input type=\"radio\" name=\"schaden\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"radio\" name=\"schaden\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/label><\/span><\/span><\/span>\n\t<\/p>\n\t<p>Already reported to any other authority?* <span class=\"wpcf7-form-control-wrap\" data-name=\"meldung\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><label><input type=\"radio\" name=\"meldung\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"radio\" name=\"meldung\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/label><\/span><\/span><\/span>\n\t<\/p>\n\t<p>The data sent will be processed only for the purpose of answering your request. Further information can be found in our <a href=\"\/en\/privacy-policy\/\" target=\"_blank\">privacy policy<\/a>.\n\t<\/p>\n\t<p><input class=\"wpcf7-form-control wpcf7-submit has-spinner\" type=\"submit\" value=\"Send\" \/>\n\t<\/p>\n<\/div><input\n                    class=\"apbct_special_field apbct_email_id__wp_contact_form_7\"\n                    name=\"apbct__email_id__wp_contact_form_7\"\n                    aria-label=\"apbct__label_id__wp_contact_form_7\"\n                    type=\"text\" size=\"30\" maxlength=\"200\" autocomplete=\"off\"\n                    value=\"\"\n                \/><div class=\"fusion-alert alert custom alert-custom fusion-alert-center wpcf7-response-output fusion-alert-capitalize awb-alert-native-link-color alert-dismissable awb-alert-close-boxed\" style=\"--awb-border-size:1px;--awb-border-top-left-radius:0px;--awb-border-top-right-radius:0px;--awb-border-bottom-left-radius:0px;--awb-border-bottom-right-radius:0px;\" role=\"alert\"><div class=\"fusion-alert-content-wrapper\"><span class=\"fusion-alert-content\"><\/span><\/div><button type=\"button\" class=\"close toggle-alert\" data-dismiss=\"alert\" aria-label=\"Close\">&times;<\/button><\/div>\n<\/form>\n<\/div>\n<div class=\"fusion-text fusion-text-2\"><p><small>* Required fields to answer your request.<br \/>\n(1) An incident according to \u201c\u00a7 29 Medical device act or \u00a7 2 sec.1 Ordinance on Medical Devices Vigilance of Germany \u201d is any malfunction, any failure or deterioration in the characteristics or performance of a medical device as well as any inaccuracy in the labelling or instructions for use which has led, or could have led, directly or indirectly, to the death or serious deterioration in the state of health of a patient or user or another person.<\/small><\/p>\n<\/div><\/div><\/div><\/div><\/div>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":7,"featured_media":3265,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","format":"standard","meta":{"footnotes":""},"portfolio_category":[59],"portfolio_skills":[],"portfolio_tags":[],"class_list":["post-3403","avada_portfolio","type-avada_portfolio","status-publish","format-standard","has-post-thumbnail","hentry","portfolio_category-service-en"],"_links":{"self":[{"href":"https:\/\/www.ceatec.de\/en\/wp-json\/wp\/v2\/avada_portfolio\/3403","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.ceatec.de\/en\/wp-json\/wp\/v2\/avada_portfolio"}],"about":[{"href":"https:\/\/www.ceatec.de\/en\/wp-json\/wp\/v2\/types\/avada_portfolio"}],"author":[{"embeddable":true,"href":"https:\/\/www.ceatec.de\/en\/wp-json\/wp\/v2\/users\/7"}],"replies":[{"embeddable":true,"href":"https:\/\/www.ceatec.de\/en\/wp-json\/wp\/v2\/comments?post=3403"}],"version-history":[{"count":2,"href":"https:\/\/www.ceatec.de\/en\/wp-json\/wp\/v2\/avada_portfolio\/3403\/revisions"}],"predecessor-version":[{"id":3491,"href":"https:\/\/www.ceatec.de\/en\/wp-json\/wp\/v2\/avada_portfolio\/3403\/revisions\/3491"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.ceatec.de\/en\/wp-json\/wp\/v2\/media\/3265"}],"wp:attachment":[{"href":"https:\/\/www.ceatec.de\/en\/wp-json\/wp\/v2\/media?parent=3403"}],"wp:term":[{"taxonomy":"portfolio_category","embeddable":true,"href":"https:\/\/www.ceatec.de\/en\/wp-json\/wp\/v2\/portfolio_category?post=3403"},{"taxonomy":"portfolio_skills","embeddable":true,"href":"https:\/\/www.ceatec.de\/en\/wp-json\/wp\/v2\/portfolio_skills?post=3403"},{"taxonomy":"portfolio_tags","embeddable":true,"href":"https:\/\/www.ceatec.de\/en\/wp-json\/wp\/v2\/portfolio_tags?post=3403"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}