Form No.: F108, Rev.

01

SUPPLIER COMPLAINT FORM Issued: 6/15/2015

Written By: C. Lease Reviewed and Approved By:
Supersedes: New
Date: 6/14/2015 R. Dobutovich, 6/15/2015

Complaint #: S19-026

Complaint Details
Product Closures, gold Report Date: 5/28/2019
Description:
Product #: RX0452IJP21000 Marine PO #: NA
(CL45
Supplier: All Merican Containers Marine Lot #: N/A
Supplier Lot #: 201810506151 Qty of Product TBD
or Material:
Nature of Complaint:
 Incorrect Packaging  Extraneous Matter  Product Defect  Medical
Description of Complaint:
Several bottles has extraneous material in the cap (appears to be paper-like material). Two random boxes
were inspected and approx.. 20-25% of caps had extraneous material.

Supplier Notification

Supplier Contact: Jon Evans Notification 5/29/2019

Date:
Supplier Investigation Response/Corrective Actions:

Reviewed and Approved

Quality Assurance: Date:

CONFIDENTIAL COMMERCIAL INFORMATION. Exempt from disclosure under Freedom of Information Act 5 USC, 522 (b)(4).
Page 1 of 3
 Form No.: F108, Rev. 01

SUPPLIER COMPLAINT FORM Issued: 6/15/2015

Written By: C. Lease Reviewed and Approved By:
Supersedes: New
Date: 6/14/2015 R. Dobutovich, 6/15/2015

Complaint #: S19-026

CONFIDENTIAL COMMERCIAL INFORMATION. Exempt from disclosure under Freedom of Information Act 5 USC, 522 (b)(4).
Page 2 of 3
 Form No.: F108, Rev. 01

SUPPLIER COMPLAINT FORM Issued: 6/15/2015

Written By: C. Lease Reviewed and Approved By:
Supersedes: New
Date: 6/14/2015 R. Dobutovich, 6/15/2015

Complaint #: S19-026

CONFIDENTIAL COMMERCIAL INFORMATION. Exempt from disclosure under Freedom of Information Act 5 USC, 522 (b)(4).
Page 3 of 3