Print #

(example for training)

Item:

Rev.

Filling car with gasoline at gas station

Model Year(s)/Vehicle(s)

POTENTIAL
FAILURE MODE AND EFFECTS ANALYSIS
(PROCESS FMEA)
Process Responsibility:

N/A

Key Date

FMEA Number:

Vehicle Owner

Prepared by:

Mike Walton

N/A

Date (Orig.)

3/1/2010

Date (Rev.)

N/A

Core Team:
Process
Function/
Requirements

Potential
Failure
Mode

Open Gas Door to

Vehicle owner cannot
Access Gas Cap (this is find lever to release door
the first step in filling the
gas tank)

Potential
Effect(s)
of Failure

S
e
v

Owner will have to ask for

assistance at the gas
station or call for help (a
fairly minor situation severity is set low at 3)

C
l
a
s
s
Minor

Potential
Causes(s)/
Mechanism(s)
of Failure
Vehicle owner not familiar
with gas door release levers
and does not have access to
owner's manual (this is a
fairly rare situation - most
vehicle owners can find the
release lever, so the rate of
Occurrence for this situation
is set at a low value of 2)

O
c
c
u
r
2

1000

Current
Process
Controls
-Prevention
-Detection

D
e
t
e
c

R.
P.
N.

No controls around owner

awareness / training
verification (practically
speaking, it is impossible to
detect when a vehicle owner
does not know where the
gas-door release lever is, so
the detection value is at the
maximum of 10)

10

60

Vehicle owner visually

detects cap on roof or sees
open gas door in side mirror
prior to departing from gas
station

175 Add strap to gas

gap so it will
never be
detached from
vehicle (in this
case, the high
RPN value
warrants action)

Recommended
Action(s)

Action Results

Responsibility
& Target
Completion
Date

No action for now N/A

- monitor service
calls and add a
visible, removable
tag to gas door
lever if complaints
are significant

Actions
Taken
N/A

(other process steps would normally be inserted here, in the the sequence that they are carried out - we are only focusing on the first
and last stetps for this example)
Replace gas cap

Owner forgets to replace Gas cap lost (the severity

gas cap, set on verhicle of this effect is higher than
roof
when the owner cannot
find the gas door lever,
since in this case the
customer may need to
purchase another gas cap)

Moderate Human error (this situation is

much more likely to happen
than the owner not being
able to find the gas door
lever - thus the Occurrence
value is much higher)

Page 1 of 4

John Smith 6/1/2011

Strap
implemented
(here's what it's
all about!
Implementing
countermeasures
to reduce risks)

Print #

(example for training)

Item:

Rev.

POTENTIAL
FAILURE MODE AND EFFECTS ANALYSIS
(PROCESS FMEA)

Filling car with gasoline at gas station

Model Year(s)/Vehicle(s)

Process Responsibility:

N/A

Key Date

FMEA Number:

Vehicle Owner

Prepared by:

Mike Walton

N/A

Date (Orig.)

3/1/2010

Date (Rev.)

N/A

Core Team:
Process
Function/
Requirements

Potential
Failure
Mode

Potential
Effect(s)
of Failure

S
e
v

C
l
a
s
s

Potential
Causes(s)/
Mechanism(s)
of Failure

Page 2 of 4

O
c
c
u
r

1000

Current
Process
Controls
-Prevention
-Detection

D
e
t
e
c

R.
P.
N.

Recommended
Action(s)

Responsibility
& Target
Completion
Date

Action Results
Actions
Taken

1000
Mike Walton
3/1/2010
N/A
Action Results
S
e
v

O
c
c

D
e
t

N/A N/A N/A

R.
P.
N.
N/A

25

Page 3 of 4

1000
Mike Walton
3/1/2010
N/A
Action Results
S
e
v

O
c
c

D
e
t

R.
P.
N.

Page 4 of 4