Complaint - Sterile Labs®

Full Name:(Required)

First Last

Best Phone Number To Reach You:(Required)

Email Address:(Required)

Quality Concern Reporting Form:

Detailed Description Of The Concern:(Required)

Select All That Apply:(Required)

Kit Tampered Upon Arrival

Missing Component

Trocar Issue

Other

Please Tell Us What Was Missing From The Kit:(Required)

Please Tell Us The Issue You Had With The Trocar:(Required)

Please Tell Us The Reason For Your Concern:(Required)

When Was The Concern Identified?(Required)

Did The Incident Occur During Patient Use?(Required)

Yes

No

Hidden

Account Information:

Hidden

Facility Name:

Hidden

Account Number:

Hidden

Contact Person:

Hidden

Contact Email Address:

Hidden

Medline Sales Rep:

Custom Pack Information:

Custom Pack Material Number:(Required)

Female Trocar Kit (DYNDA2855)

Male Trocar Kit (DYNDA2856)

Custom Pack Lot Number:(Required)

Total Quantity Of Affected Packs:(Required)

Affected Component Number/Description:(Required)

Are You Sending A Sample?(Required)

Yes

No

Can You Send A Picture?(Required)

Yes

No

Upload Picture(s)

Drop files here or

Accepted file types: jpg, png, pdf, Max. file size: 512 MB.

Hidden

Requested Actions From SPT Quality:

Hidden

Quality Feedback Form

Quality Concern Reporting Form:

Account Information:

Custom Pack Information:

Requested Actions From SPT Quality:

Order Support Send us a chat to ask quick questions

Get In Touch!

Additional Resources

Account