Superlab Unified Incident Report

All incidents must be reported within 2 hours via this form, regardless of severity.

Fields marked with * are required.

Section 1

Basic Information

Superlab Location*

Date & Time of Incident*

Submitted By*

Witnessed By

Client / Member Affected

Internal Team Affected

Section 2

Incident Type

Select all that apply*

Alarm notification

Equipment malfunction

Temperature deviation

Chemical spill

Biological spill

Facility damage

Safety incident

Near miss

Environmental issue

IT Network issue

Vendor failure

Other

Section 3

Equipment / System Involved

Select all that apply

Freezer (-20/-80)

LN2 system

Incubator

Fume hood

HVAC Ventilation

Power UPS

Water Drain

Autoclave

Imaging equipment

Robot Automation

IT network

Security Envoy

Other

Section 4

Description of Incident

What happened (facts only)*

Who reported first

Room / Equipment ID

Alarm triggered

Attachments / Photos

Describe or list any attached files

Section 5

Timeline

Provide accurate timeline of events

Use format: HH:MM — Event description. Add one event per line.

Section 6

Impact

Clients affected

Samples lost

Equipment damaged

Safety risk

Business interruption

Estimated financial impact (CHF)

CHF

Section 7

Actions Taken

Select all actions taken

Area secured

Client informed

Vendor contacted

Maintenance called

Internal escalation

Backup freezer used

No action required

Section 8

Root Cause Analysis

Root Cause Category

Root Cause Description

Preventive Action

Responsible Person

Deadline

Section 9

Severity Classification

Ready to submit?

Review all sections before submitting. This report will be sent to Airtable.