Event Informarion

  • Material / Product:

  • Lot No.

  • Test:

  • Method No: / Rev. / Method Tittle / Effective Date

  • Initial Result

  • Specification:

  • Test Date:

  • When the event was detected (Date of Occurence):

  • Description of Event (What Happened):

  • The data generated is accurate (i.g. System Suitability was within specifications, elements of the analysis were found correct)

  • Type of Result

  • Inmediate Correction:

  • Initial Impact Assesment (What is the extention of the event)

Laboratory Investigation:

Analyst Evaluation

  • The analyst that perform the analysis was qualified to perform the analysis?

  • The analyst has experience in the analysis (He/She performed the test on the past)?

Standard Preparation Evaluation

  • The Standard Weight are correct?

  • The Glassware used was correct

  • Standard preparation reference:

  • The standard preparation was performed as per method instructions?

Sample integrity

  • Did sample was received in the correct container

  • Did the sample came in a bag with desicant?

  • The sample was stored in the correct area (Document the area of storage (If applicable document the humidity of the room)

Sample Preparation Evaluation:

  • The sample was received in the appropriate container

  • The glassware used in the analysis is correct (i.g. volumetric flask, pippets, etc)?

  • The sample weight performed was correct?

  • The solution used for the sample preparation is correct (Reference)

  • Evaluate the sample preparation against the method instruction with the analyst. That any deviation or error was found?

  • Re-measutements was performed?

  • Results of re-measurements

  • The original result was confirmed??

  • If the OOS was confirmed, open and investigation to other area (i.g. Mfg, MTDP etc) to expand the investigation process. Refer to:Root

Instrument Evaluation

  • Instrument used

  • Calibration Due Date:

  • The instrument was verified and it was detected an error (i.g leak, error message, etc)

  • All the instrument parameters were correct (No error message or equipment malfuntion was detected)


  • Re-Test Performed?

  • Re-Test Results (Document)

  • Did re-test results confirmed the original results

Trending Evaluation

  • Evaluate the history the previous year and document the findings

Root Cause

  • Laboratory Root Cause

  • Trackwise Root Cause

Correction or Corrective Action

  • Type:

  • Action Taken

Preventive Action (This prevent the recurrence of the root cause identified)

  • Action Taken

Final Conclusion

  • Describe the results that will be used as official to report the test.

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. Any ratings or scores displayed in our Public Library have not been verified by SafetyCulture for accuracy. Users of our platform may provide a rating or score that is incorrect or misleading. You should independently determine whether the template is suitable for your circumstances. You can use our Public Library to search based on criteria such as industry and subject matter. Search results are based on their relevance to your search and other criteria. We may feature checklists based on subject matters we think may be of interest to our customers.