Below is the latest version of the Incident and Malfunction Report FORM for Los Deline hydrophilic gel.

This form should be used to report in the case of device malfunction events and medical device incidents . After completion of the forms below, please E-MAIL within 48 hours to:


e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.

tel.: +420 228 226 171


or mailed via courier to:


Biotrh s.r.o.

Safety department,

Lyčkovo náměstí 508/7,
Praha 8,
186 00,
Czech Republic



Incident Report Form (.pdf)  
Incident Report Form (.docx)  


Karlovo náměstí 17,
120 00 Prague 2
Czech Republic
phone: +420 228 226 171

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