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Regulatory Flashcards

1
Q

ORA

A

office of regulatory affairs, subset of the FDA responsible for inspections every two years

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2
Q

FDA’s five layers or blood safety

A
  1. Donor screening 2. Donor Deferral 3. Infectious Disease Testing 4. Quarantine (all units quarantined until ID testing is complete 4. Problems and deficiencies
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3
Q

Five categories that ORA and FDA inspect for:

A
  1. Quality assurance 2. Donor eligibility 3. Product testing 4. Quarantine and inventory management 5. Production and processing
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4
Q

FDA form 483

A

Form served upon inspection to notify manufacturer of objectionable conditions and does not constitute a final determination of whether a violation has occurred.

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5
Q

CBER

A

centers for biologics, evaluation and research. A subset of the FDA, gets all the reports of blood related fatalities

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6
Q

Categories of FDA enforcement actions

A

advisory, administrative or judicial

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7
Q

BPD

A

blood product deviation reporting. (21 CFFR 606.171) all required to report BPD on distributed products. Must not exceed 45 days from date of becoming AWARE of incident.

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8
Q

When is reverse typing of donors not applicable

A
  1. confirmation testing of labeled previously typed donor red cells 2. Infants less than 4 months
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9
Q

Reasons for Weak ABO front type

A

Leukemia or other malignancy, and inheritance of weak ABO subgroup

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10
Q

How long do you have to report a BPD to the FDA

A

45 days from when the manufacturer became aware of the issue

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11
Q

Recall

A

Remoal of product that is in violation of the law (Class categories 1, 2 and 3)

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12
Q

Market Withdrawal

A

minor violation not subject to FDA legal action, manufacturer voluntarily removes product or corrects violation

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13
Q

BSL levels 1-4 what types of precautions/infectious agents

A

BSL1- no to minimum risk of causing human disease-open bench top (pH water)
BSL2- TS, CBC, moderate risk decrease transmission must have PPE and biohazard warning
BSL3- M. Tuberculosis, directional airflow and HEPA Filter
BSL4- EBOLA, negative pressure, HEPA filtered supply, and exhaust, airlock entry ports changing and decontamination area.

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14
Q

If blood production company creates products AND ships across states lines you need what:

A

To be registered and Licensed by the FDA, license number needs to be on the outside of the bag

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15
Q

If blood production company only creates products and distributes within state, needs to be…

A

Registered with the FDA, does not need to be licensed

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16
Q

How to obtain a license for a blood production facility

A

obtain license by submitting a BLA to the FDA

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17
Q

BLA

A

biologics license application

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18
Q

Changes made to manufacturing

A

Must update with FDA any changes in manufacturing from license application

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19
Q

CBER

A

center for biologics evaluation and research- lead on devices for blood manufacturing, HPCs and RBC collection

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20
Q

CFR Title 21-803

A

Any serious injury or death related to medical device must be reported to the FDA

21
Q

CFR portion of regulation for blood components

A

FDA CFR Title21 Parts 600,601,606,607,610,630,640

22
Q

CFR process production controls, equiptment, regulations and quality control

A

21 CFR 211

23
Q

ORA inspections

A

every two years

24
Q

CPGM

A

compliance program guidance manual for inspection of licensed and unlicensed blood products

25
CMS and CLIA
CMS requires labs to be registered with CLIA in order to receive reimbursement for/from medicare and medicaid
26
CLIA requirements for PT
pt= proficiency testing, requires participation of lab in PT program for any nonwaived testing
27
Tests rating
Rated by complexity lowest level is waived then moderate and then high. Waived tests are typically POC testing such as urine dipsticks etc. simple and easily performed iwth limited tech training
28
High complexity testing
infectious disease testing and compatibility testing
29
Blood banks 3 pathways to obtain CLIA registeration
1. certificate of compliance approval via state health department inspection 2. certificate of accreditation approval via CMS approved accrediting organization 3. cms exempt: license program for nonwaived labs in NY or WA accepted by CMS.
30
CMS 6 approved accreditation
1. AABB 2.CAP 3.JAICO 4. ASHI- american society for histocompatibilty and immunogenetics 5. American osteopathic association 6. COLA commission office lab association
31
AABB/CAP inspections
needs to be inspected every two years to maintain accreditation
32
HCT/P's
human cells tissue and cellular tissue based products, can be derived from living or dead donors
33
HCT/P's from deceased donors
skin, dura mater (tough underlayer of brain and spinal chord) cardiovascular tissues, ocular tissues, musculoskeletal tissues
34
HCT/P's from live donors
hematopoietic stem progenitor cellsf rom peripheral cord blood, reproductive cells and tissues and other cellular therapy products (pancreatic islets, mesencymal stem/stromal cells, and fibroblasts)
35
Four rules HCT/P regulated solely under section 361 of PHS and CFR21,1271 must meet:
1. minimally manipulated 2. intended for homologous use only- same function in recipient as in donor 3. not combined with another regulated article 4. does not have systemic effect, not dependent on metabolic activity. If it does not meet criteria listed above must be regulated as drug device or biological product under FD and C act
36
FACT
foundation for accreditation and cellular therapy
37
QC portion of quality assurance program (6)
reagent QC, product QC, clerical checks, visual inspections, temp readings, volume or cell counts on finished blood components
38
Statistical tools in quality management
1. process capability measurement 2. control charts
39
Near Miss event
wrong in tube scenario where patient was not transfused. An error or deviation from standard procedures discovered prior to starting the transfusion which could have led to a reaction in the recipient. WBIT detected before issue or detection of wrong pack of blood being brought to bedside
40
What are the seven elements of the compliance program
Mandated by the Office of Inspector General (OIG) regulations. 1. Compliance oversight 2. written policies, procedures and standards 3. training and education 4. communication and reporting 5. disciplinary protocols 6. risk assessment 7. auditing and monitoring
41
What is the role of the officer of the inspector general
1. imposes penalties, sanctions, exclusions for misconduct 2. published compliance program guidance in 1997 3. revised and refined in 1998 4. basis for lab's compliance program 5. mandatory element of compliance program is annual training
42
Why do labs need to have a compliance program
mandated by patient protection and affordable care act-2009
43
ABN
advance beneficiary notice- if codes do not pass medical necessity for patients with medicare an ABN is created. , patient has choice of signing the form and taking responsibility for payment or refusing the service.
44
CPT codes
are assigned to each lab test, the codes are used by insurance companies and medicare administrative contractors to identify the service provided and amount of reimbursement
45
PHI
protected health information is individually identifiable information transmitted by or maintained in any form.
46
Breach of PHI
any potential breach of PHI must be documented
47
How long do you have to add AS to unit after collected
72 hours
48
What is the concentration of rbc units, what's in there
30-40 mL CPD and plasma, 100mL of AS and 150-230 mL of blood for 50-60% hct, or 60-70mL of CPDA-1 for 70-80% hct, >80% not acceptable
49
What's humate P and alphanate
Both factor 8 concentrates that have vwf and can be used to treat either vwd or hemophilia a

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