Corrective Action Request
CAR (NMR) Number_______
To: From:
Issue Date: Effective Date:
Comments (Optional):
You are requested to review the discrepancies on the attached NMR, check related products for potential problems and provide a written response on page 2 of this form within 10 working days of request date.
1. Use the Team Approach (List names and titles of all personnel who participated in the problem resolution):
Response:
2. Problem Description (Provide a brief description of the problem.):
Response:
3. Containment and Short Term Corrective Action (Identify the number of lots involved and short term action taken, i.e. 2 lots. in stock - 100% tested - 3 units scrapped, etc.):
Response:
4. Define and Verify Root Cause (Report the true root cause - not to be confused with a symptom. Ask the question "why" until a true root cause is established.):
Response:
5. Implement and Verify Permanent Corrective Action (Identify the fix and report what was done to verify the problem has been resolved., i.e. checked 5 lots. and all were found to be within specification.):
Response:
6. Prevent Recurrence (Identify what prevention measures have been incorporated to ensure the problem does not re-occur.):
Response: