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Corrective Action Form - api-pt.com

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Checklist for Corrective Action Year/Testing Event_____________ Analyte_____________ Sample number_________Date Sample Tested________________ Person Performing Test_________________________ Specimen Handling Were specimens received in an acceptable condition? Yes No Were specimens stored according to the instructions on the result forms? Yes No Were the samples hemolyzed? Yes No Were samples tested within the time allowed for sample stability? Yes No If applicable, were the samples reconstituted correctly? Yes No Notes:__________________________________ ________________________________________ ________________________________________ ________________________________________ ________________________________________ __________________________________ Clerical Errors Yes No Yes No Yes No Were the results transcribed onto the worksheets correctly?

Instrument Were instrument problems noted the day the samples were tested? Yes No Has there been any recent maintenance on the analyzer?

  Action, Corrective, Corrective action

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