Get M05.01.01.01 Rev 22 Product Experience Report-editable Version.docx

This guide provides a clear and professional walkthrough on completing the M05.01.01.01 Rev 22 Product Experience Report online. By following these instructions, users can ensure that they submit all necessary information accurately, aiding in compliance and continuous improvement.

Follow the steps to successfully complete the product experience report.

1. Click the ‘Get Form’ button to access the form and open it in your preferred editor.
2. Begin by filling out the 'A. Reporter Information' section. Include your name, the date of the report, and specify your affiliation (clinician, lab, distributor, etc.). Ensure each required field is completed, as missing information will delay processing.
3. In the 'B. Product Information' section, record the item number, lot or serial number, and quantity of the products involved. If applicable, indicate if the product is being returned and provide details on decontamination and replacement item requests.
4. Move to the 'C. Event Information' section. Input the placement date, event date, and removal date. Describe the event thoroughly, including any patient impact and other relevant details about the occurrence.
5. In 'D. Patient Information', provide the patient identifier, weight, and dental notation. Record any noted patient conditions relevant to the incident.
6. If applicable, complete the 'E. Patient Specific Product Only' section with details about specific products used and any issues encountered during the procedure, including seating and fitting of components.
7. Review all fields to ensure completeness and accuracy. Ensure required sections are properly filled out to avoid delays.
8. Finally, save your changes. You can opt to download, print, or share the completed form for submission as necessary.

Complete your product experience report online today to support compliance and improvement efforts.