Questionnaire for market observation
Port catheter systems

Customer feedback form - user

Dear Sir or Madam,

Against the background above, we are dependent on your support within the framework of the practical implementation of the EU Regulation 2017/745 enacted by European Parliament and the Council.
Feedback from long-standing customers and users, who have known and used our products for a long time and are therefore able to evaluate them adequately, is of particular help to us.
The evaluation of your answers is anonymous and no conclusions about individual customers and patients are included in the corresponding evaluation.

The questionnaire is divided into the following topics:

I. Information on the feedback provider (medical background)
II. General product information
III. Patient group to be treated
IV. Implantation and application of the implant (port catheter system) and its components
V. Remarks/comments

We kindly ask you to take a few moments to answer the questionnaire. The questionnaire will take about 5-10 minutes to complete.
Your answers will help us to improve medical products in the future, to make them even safer and to make them available in the usual form.

Thank you very much for your support!
The team of PakuMed gmbh


PakuMed medical products gmbh

Im Löwental 79
45239 Essen

Phone: +49 201 – 43 70 97 – 0


Satisfaction(0=Not at all satisfied, 4=very satisfied):

Evaluation of the individual components of the port catheter systems:

Please answer these questions if you have been in contact with the accessories.

Satisfaction (0= Not at all satisfied, 4=very satisfied)


Vein hook:

Rinsing Needle:

Port cannula PK 0925:

Introducer Set:




Workflow and Compatibility:

Suggestions for improvement:

Training needs: