Report a potential product defect

Photo Upload

Please support the investigation process by attaching multiple photos of the defect(s) and its packaging from all sides.

Upload photos

Max files: 15
Max overall size 20 MB
Permissible file types: .png, .gif, .jpg, .bmp, .pdf

Consideration for photos

What to photograph

Take photos of: 1. Defect(s) with all relevant angles, 2. product with all sides, 3. packaging with all sides. Ensure product details like product strength, expiry date and batch / lot number are clearly visible.

How to take the photographs

Ensure the photos are well-lit and sharp.

Consideration for photos

What to photograph

Take photos from: The product displaying the defect - from all relevant angles, containing all relevant details.

How to take the photographs

Ensure the photos are well-lit and sharp.

Complaint Details Continued

Please answer the following questions to the best of your knowledge.

How was the product stored?

How long have you/patient/caregiver been using the product?

Was the product administered at home or in a medical environment (e.g. doctors office)?

By whom?

Please provide the date of complaint occurrence:

Was there a delay in administration of the product as a result of this complaint?

Did the administrator of the product receive any handling training?

Has this complaint also been reported via an additional channel (e.g. Health Authority / Call center/ Pharmacy)?

Have there been any side effects involved?

Personal Details

Are you a…

Do you want to be informed about the outcome of the complaint investigation?

I consent to my personal data being processed for the purpose of responding to my inquiry and in accordance with the Roche privacy notice.

You consent, by ticking the box above, to the processing of your personal data for the purposes of responding to your inquiry and in accordance with the Roche Privacy Notice. If you do not consent to the personal data processing, we will not be able to reply to your message and kindly ask you to use other channels to contact us.

Roche Ukraine LLC ("Roche") has legal obligations to record and/or report product complaints. Therefore, for such purposes your data will be processed in accordance with legislation, as further described in the Roche privacy notice.

Roche will keep a record of the personal data that you provide for the purpose of responding to your inquiry, to follow up on such requests, to maintain the information in the Roche medical information database for reference and to comply with our legal and regulatory obligations. The retention time of data is in accordance with respective laws and regulations.

By including personal data of another data subject in the form, you represent the lawfulness of processing of such personal data.

The Roche privacy notice provides further detailed information about your rights and how Roche processes personal data.

Report a potential product defect

Product Selection

For which Roche product do you have a complaint?

Do you suspect a product falsification?

Product Information

Product selected

Please select the procedure to which your concern relates:

Please select your product type (dosage form).

Is your product available for return?

Complaint Details

How is it different from "normal"? Please add a detailed description of the defect (e.g. appearance, damage, leakage).

Describe when exactly you discovered the defect (e.g. when opening the box, before the administration, after the administration, at which handling step according to instructions of use or patient information leaflet)

Photo Upload

Consideration for photos

Consideration for photos

Complaint Details Continued

How was the product stored?

How long have you/patient/caregiver been using the product?

Was the product administered at home or in a medical environment (e.g. doctors office)?

By whom?

Please provide the date of complaint occurrence:

Was there a delay in administration of the product as a result of this complaint?

Did the administrator of the product receive any handling training?

Has this complaint also been reported via an additional channel (e.g. Health Authority / Call center/ Pharmacy)?

Have there been any side effects involved?

Personal Details

Are you a…

Do you want to be informed about the outcome of the complaint investigation?

Product Selection

For which Roche product do you have a complaint?

Do you suspect a product falsification?

Product Information

Product selected

Please select the procedure to which your concern relates:

Please select your product type (dosage form).

Is your product available for return?

Complaint Details

How is it different from "normal"? Please add a detailed description of the defect (e.g. appearance, damage, leakage).

Describe when exactly you discovered the defect (e.g. when opening the box, before the administration, after the administration, at which handling step according to instructions of use or patient information leaflet)

Photo Upload

Consideration for photos

Consideration for photos

Complaint Details Continued

How was the product stored?

How long have you/patient/caregiver been using the product?

Was the product administered at home or in a medical environment (e.g. doctors office)?

By whom?

Please provide the date of complaint occurrence:

Was there a delay in administration of the product as a result of this complaint?

Did the administrator of the product receive any handling training?

Has this complaint also been reported via an additional channel (e.g. Health Authority / Call center/ Pharmacy)?

Have there been any side effects involved?

Personal Details

Are you a…

Do you want to be informed about the outcome of the complaint investigation?

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