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Dev./Pkg : Reference # :
Company Name :
Location :
Contact : Name :
Phone :
Fax :
Emailid :
Author :
Date :
Summary/Abstract :(What quantifiable effect was experienced by the customer that indicates
the existence of a problem? Summarize root cause and findings.)
What : (What is wrong with what? State the problem in terms of object and defect)
Where: (Where did the problem first show up? Name other product lines that have the same problem.
Where on the object is the problem occurring? Where in the process flow did the problem 1st develop?
When: (When did the problem first develop? Describe any pattern with regards to time, e.g., random, chronic,
intermittent, day 1, etc.. Describe when in the process and life cycle the problem first occurred.)
How big: (Describe the size of the problem or defect. Describe the failure rate.)
4.4 Does the root cause explain all the facts compiled in the problem description?
Yes No
5.2 Show evidence that the chosen action can resolve the problem at root cause level.
5.3 Define perm. corrective action for the escape point. Show evidence of effectiveness.
6.3 Are the corrective actions affecting the following documented and updated?
YES NO N/A
Systems
Practices
Procedures
Documents
6.4 How will long-term results of the corrective actions be measured to prove that the root
cause is really eliminated?
7.3 Is there a need to cascade corrective and preventive actions to other product lines?
Yes If yes, identify product line(s) :
No
7.4 Have all the changes to procedures and policies been updated?
Yes No Spec No. Effective date
Process Specs
Maintenance Specs
FMEA
Control Plan
7.6 Indicate the safe cut-off date code that the product will no longer have a problem.
8.0 Team and Individual Recognition (Recognize team and individual contributions to the resolution of
the problem.)