Product complaint for Fluid Management Tech. & Fermentation

FMT/FRT Complaints

Health and Safety Information

Sartorius is committed to protecting the health and safety of its employees.

Please note that the list of all products in contact with the Sartorius product must be declared (before decontamination and for decontamination if applicable).
All returned samples must be rendered safe to handle (decontaminated if applicable) and must include safe handling instructions (safety documentation such MSDS material safety data sheet or SDS safety data sheet).
Even if the sample has been in contact with non-dangerous substances as media or buffer, the sample must be at least drained and rinsed twice (final rinsing) before any return

The return authorization will be given only after safety aspect review. Investigation can only been started once the documentation has been completed. Decision of handling a used bag remains the prerogative of Sartorius.

Safety rules:
No sample that has been in contact with a biological agent of classes 2, 3 or 4 (meaning pathogenic) can be accepted.
No filled sample will be received.
Samples found contaminated at receipt will not be investigated.

Product in contact with Sartorius sample information

Has returned sample been in contact with a radioactive compound? *

Yes No

Has a biological agent been in contact with the product?*

Yes: micro-organism (bacteria, viruses, fungi)

Yes: prion

Yes: human endoparasite

Yes: human cell or tissue

Yes: animal cell or tissue

Yes: GMO

Yes: other (specify below)

Have other agents come in contact with the product? *

Yes (please fill out the according row below) No

If media or buffer is home-made please indicate the composition of the solution in contact (Fill one raw per compound : give name and magnitude)

Decontamination

Sartorius safety rules: Even if the sample has been in contact with non-dangerous substances as media or buffer, the sample must be at least drained and rinsed twice (final rinsing) before any return

Select a Decontamination Method:*

Physical Decontamination

Chemical Decontamination

No Decontamination or decontamination with water only, rinsed twice.

Confirm that a double final rinsing was performed: *

Yes (please give the volume used for each rinsing (in liter) and pH of last rinsing water) No

Can the sample be safely transported as non-hazardous material? *

Yes No

Require Contact Name and email for Health and Safety questions:

Name: *

E-Mail: *

SDS (for each compound and serological status for human product derived) attached.

Yes No

Additional documents and proofs

Please add material safety data sheets (MSDS) and other relevant documents. Max. 10 Files | 100 MB

Upload File

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Review Statement

I hereby confirm that all above information entered in this form is accurate to the best of my knowledge. *

Name and function *

Date & Signature (Required when printed and placed in with Return Sample otherwise investigation cannot be initiated)

* These fields are required Information on the use of your data can be found in our privacy policy

	Name	%Soln.
Media Compound
Buffer Compound
Monoclonal Antibody
Toxins
Other Protein of Interest
Other Additive
Other Chemical

Product complaint for Fluid Management Tech. & Fermentation

FMT/FRT Complaints

Customer Information

Product Information

Incoming Inspection

Storage Conditions (for stages of detection after incoming control)

Issue Description and Detection

Post/During Use Questions

Post Use/During Use Leaks

During or Post Use Malfunction

Pre Use or Post Use Integrity Test Failure

During or Post Use Other

During or Post Use Additional Information

Sample Return Information

Health and Safety Information

Product in contact with Sartorius sample information

Decontamination

Additional documents and proofs

Review Statement