Report a Device Issue

Use this form to report a problem with a Nova Vascular device. We review every submission in accordance with our Quality Management System. If you are reporting a medical emergency, please call 911 before submitting this form.

Step 1 — Your contact information
Step 2 — Device identification

Printed on the back label of the device.

14-digit number under the barcode on the label.

Includes lot and manufacturing date.

Step 3 — Patient information (if applicable)
Please minimize personal health information. For investigation we need only the patient's initials and date of birth. Do not enter full names, Social Security numbers, addresses, or medical record numbers. You may skip this section if the report is not about a specific patient event.
Step 4 — Event details

Your report will be logged verbatim for investigation.

Step 5 — Did harm occur?

This section helps us determine whether we need to file a Medical Device Report with the FDA. Please answer to the best of your knowledge.

A "serious injury" is one that is life-threatening, results in permanent impairment, or requires medical or surgical intervention to prevent permanent impairment.

Step 6 — Acknowledgement

After submission you will receive an email confirmation. A member of our team will contact you within 5 business days.