Being ISO/AS for 10 yrs now we went through alot and it has taken us 10 yrs to fine tune our system. We still go through this (Is it a system error or a personnel issue). We have (sorry, but dumby-proof) the system so much that when a 10 year operator just doesn't follow the work instructions it's a personnel issue and it goes in their employee file. There's gotta be a time when it isn't the system. When an employee has been trained over and over and they just seem to make the same mistakes again and again than you have to start banging your head against the wall. I just had one today where the material needed to run the job was clearly stated in the work instructions, the lead man and supervisor injected the dies using a different wax. Luckily the customer agreed to buy it. Now both of these individuals have been at their jobs for 13+ years. Sorry nothing wrong with the system here and their were no phone calls about deaths in those two people's life's. It was a Friday afternoon and all they thought about was the week-end.