Title Page
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State/ Site
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Date Performed
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Check Performed By
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DEMO LABEL AND BROKEN SEAL/ STERILITY >>> CARDIOVASCULAR (indicate specific OU in the Notes, when possible; e.g. CAS, CS, CRM + CDS, CRDN, SH, APVH) Randomly select minimum of 5 units (if qty available) from each shelf. Products inside travel cases, bags or boxes may be randomly included. Check that product has: a. large demo label on the packaging (if any) b. Name is still a Medtronic employee; Review date is not past due c. and small demo label on the product itself d. any seal or sterility is broken If Fail, list non-compliant OU/s in the Notes
- Pass
- Fail - but corrected on the spot
- Fail - further action required
- N/A
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DEMO LABEL AND BROKEN SEAL/ STERILITY >>> NEUROSCIENCE (indicate specific OU in the Notes, when possible; e.g. Neuromodulation & Pelvic Health, CST, ENT, NV) Randomly select minimum of 5 units (if qty available) from each shelf. Products inside travel cases, bags or boxes may be randomly included. Check that product has: a. large demo label on the packaging (if any) b. Name is still a Medtronic employee; Review date is not past due c. and small demo label on the product itself d. any seal or sterility is broken If Fail, list non-compliant OU/s in the Notes
- Pass
- Fail - but corrected on the spot
- Fail - further action required
- N/A
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DEMO LABEL AND BROKEN SEAL/ STERILITY >>> MEDICAL SURGICAL (indicate specific OU in the Notes, when possible; e.g. GI, PM & RI, SI, SR) Randomly select minimum of 5 units (if qty available) from each shelf. Products inside travel cases, bags or boxes may be randomly included. Check that product has: a. large demo label on the packaging (if any) b. Name is still a Medtronic employee; Review date is not past due c. and small demo label on the product itself d. any seal or sterility is broken If Fail, list non-compliant OU/s in the Notes
- Pass
- Fail - but corrected on the spot
- Fail - further action required
- N/A
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DEMO LABEL AND BROKEN SEAL/ STERILITY >>> DIABETES Randomly select minimum of 5 units (if qty available) from each shelf. Products inside travel cases, bags or boxes may be randomly included. Check that product has: a. large demo label on the packaging (if any) b. Name is still a Medtronic employee; Review date is not past due c. and small demo label on the product itself d. any seal or sterility is broken If Fail, list non-compliant OU/s in the Notes
- Pass
- Fail - but corrected on the spot
- Fail - further action required
- N/A
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GENERAL HOUSEKEEPING AND SAFETY >>> CARDIOVASCULAR (indicate specific OU in the Notes, when possible; e.g. CAS, CS, CRM + CDS, CRDN, SH, APVH) Visually check for presence of (a) unnecessary items, and/or (b) cases, boxes, crates, transport bags, etc blocking the walkways or obstructing fire sprinkler or extinguisher. If Fail, list non-compliant OU/s in the Notes
- Pass
- Fail - but corrected on the spot
- Fail - further action required
- N/A
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GENERAL HOUSEKEEPING AND SAFETY >>> NEUROSCIENCE (indicate specific OU in the Notes, when possible; e.g. Neuromodulation & Pelvic Health, CST, ENT, NV) Visually check for presence of (a) unnecessary items, and/or (b) cases, boxes, crates, transport bags, etc blocking the walkways or obstructing fire sprinkler or extinguisher. If Fail, list non-compliant OU/s in the Notes
- Pass
- Fail - but corrected on the spot
- Fail - further action required
- N/A
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GENERAL HOUSEKEEPING AND SAFETY >>> MEDICAL SURGICAL (indicate specific OU in the Notes, when possible; e.g. GI, PM & RI, SI, SR) Visually check for presence of (a) unnecessary items, and/or (b) cases, boxes, crates, transport bags, etc blocking the walkways or obstructing fire sprinkler or extinguisher. If Fail, list non-compliant OU/s in the Notes
- Pass
- Fail - but corrected on the spot
- Fail - further action required
- N/A
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GENERAL HOUSEKEEPING AND SAFETY >>> DIABETES Visually check for presence of (a) unnecessary items, and/or (b) cases, boxes, crates, transport bags, etc blocking the walkways or obstructing fire sprinkler or extinguisher. If Fail, list non-compliant OU/s in the Notes
- Pass
- Fail - but corrected on the spot
- Fail - further action required
- N/A