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Device Accountability Log: PI NAME, Protocol or IRB Number, Protocol Short Title Page of

This document is a device accountability log used to track medical devices involved in research studies. It contains columns to record information about receiving devices, using them with study subjects, and their final disposition including return, destruction or repair. Staff initials are included to confirm the logging of all device movements and use.

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Anusha Denduluri
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69 views1 page

Device Accountability Log: PI NAME, Protocol or IRB Number, Protocol Short Title Page of

This document is a device accountability log used to track medical devices involved in research studies. It contains columns to record information about receiving devices, using them with study subjects, and their final disposition including return, destruction or repair. Staff initials are included to confirm the logging of all device movements and use.

Uploaded by

Anusha Denduluri
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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PI NAME, Protocol or IRB Number, Protocol Short Title Page of

Device Accountability Log

Device Receipt Device Use Device Return/Repair/Destruction

Confirmed by (staff initials)


(staff initials)Dispensed by
initials)Received by (staff

Date of final Device


Model Number(s)
Batch # or Device

Subject Study ID
Lot #, Serial #, or
Date Received

Disposition
Date Used
Type

Device
Disposition

RET=Returned
DES=Destroyed
REP=Repaired Reason Comments

Form Number: Version Date: 01/29/2016

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