Aurora Health Center-Elkhorn

CLIA Laboratory Citation Details

2
Total Citations
8
Total Deficiencyies
4
Unique D-Tags
CMS Certification Number 52D0671419
Address 201 E Morrissey Dr, Elkhorn, WI, 53121
City Elkhorn
State WI
Zip Code53121
Phone(262) 723-3100

Citation History (2 surveys)

Survey - March 30, 2021

Survey Type: Standard

Survey Event ID: JUW211

Deficiency Tags: D5421 D5421

Summary:

Summary Statement of Deficiencies D5421 ESTABLISHMENT AND VERIFICATION OF PERFORMANCE CFR(s): 493.1253(b)(1) Each laboratory that introduces an unmodified, FDA-cleared or approved test system must do the following before reporting patient test results: (1)(i) Demonstrate that it can obtain performance specifications comparable to those established by the manufacturer for the following performance characteristics: (1)(i)(A) Accuracy. (1)(i) (B) Precision. (1)(i)(C) Reportable range of test results for the test system. (1)(ii) Verify that the manufacturer's reference intervals (normal values) are appropriate for the laboratory's patient population. This STANDARD is not met as evidenced by: Based on surveyor review of laboratory records and interview with the technical consultant, the technical consultant did not review the performance specification verification records on the new Sure-Vue serum human chorionic gonadotropin (HCG) test kit prior to reporting patient results. Findings include: 1. Review of "hCG Patient Test Log" showed the laboratory started reporting patients using the Sure-Vue serum HCG test kit on November 18, 2020. 2. Review of the "Method Validation Checklist" form showed the technical consultant reviewed and signed the validation checklist on December 31, 2020. Further review showed the "Date Method Implementation" was January 4, 2021. 3. Interview with the technical consultant on March 30, 2021 at 10:00 AM confirmed the technical consultant did not review and accept the performance specification verification records on the new Sure-Vue serum HCG test kit prior to reporting patient results. Statement of Deficiencies (X1) Provider/Supplier/CLIA Identification Number (X3) Date Survey Completed Name of Provider or Supplier Street Address, City, State -- 1 of 1 --

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Survey - January 29, 2019

Survey Type: Standard

Survey Event ID: EIN111

Deficiency Tags: D5417 D5437 D6072 D5417 D5437 D6072

Summary:

Summary Statement of Deficiencies D5417 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT CFR(s): 493.1252(d) Reagents, solutions, culture media, control materials, calibration materials, and other supplies must not be used when they have exceeded their expiration date, have deteriorated, or are of substandard quality. This STANDARD is not met as evidenced by: Based on surveyor observation of reagents in the laboratory and interview with the technical consultant, the Sedistain available for use at the microscope expired on April 29, 2018. Findings include: 1. Observation of reagents available by the microscope in the laboratory on January 29, 2019 at 3:45 PM revealed a bottle of Sedistain, lot 1605 006. The expiration date listed on the bottle was April 29, 2018. 2. Interview with the technical consultant on January 29, 2019 at 3:45 PM confirmed the Sedistain was past its expiration date and was available for use for urinalysis microscopic testing. D5437 CALIBRATION AND CALIBRATION VERIFICATION CFR(s): 493.1255(a) Unless otherwise specified in this subpart, for each applicable test system the laboratory must perform and document calibration procedures-- (1) Following the manufacturer's test system instructions, using calibration materials provided or specified, and with at least the frequency recommended by the manufacturer; (2) Using the criteria verified or established by the laboratory as specified in 493.1253(b) (3)-- (2)(i) Using calibration materials appropriate for the test system and, if possible, traceable to a reference method or reference material of known value; and (2)(ii) Including the number, type, and concentration of calibration materials, as well as acceptable limits for and the frequency of calibration; and (3) Whenever calibration verification fails to meet the laboratory's acceptable limits for calibration verification. Statement of Deficiencies (X1) Provider/Supplier/CLIA Identification Number (X3) Date Survey Completed Name of Provider or Supplier Street Address, City, State -- 1 of 2 -- This STANDARD is not met as evidenced by: Based on surveyor review of calibration records for the Poch 100i hematology analyzer and interview with the technical consultant, the laboratory did not calibrate the analyzer every six months in 2017 as required in their procedures. Findings include: 1. Review of calibration records for the Poch 100i analyzer showed no record of calibrations between July 2016 and September 2017. 2. Interview with the technical consultant on January 29, 2019 at 3:15 PM confirmed calibration is required every six months and the laboratory did not perform calibration of the Poch 100i analyzer between July 2016 and September 2017. D6072 TESTING PERSONNEL RESPONSIBILITIES CFR(s): 493.1425(b)(3) Each individual performing moderate complexity testing must adhere to the laboratory's quality control policies, document all quality control activities, instrument and procedural calibrations and maintenance performed. This STANDARD is not met as evidenced by: Based on surveyor review of quality control procedures and records, and patient test result logs, and interview with the technical consultant, testing personnel performed serum human chorionic gonadotropin (hCG) testing on four days in September and October 2018 without testing serum quality control material as required in the laboratory's Individualized Quality Control Plan (IQCP). Findings include: 1. Review of the IQCP for serum hCG testing showed testing of Quidel low positive and negative serum control material on the first Monday of the month and with each new lot number of the test kit is required. 2. Review of the 2018 quality control log for the QuickVue+ hCG test showed no record of serum quality control testing on lot number 704249 between September 24 when the laboratory first used the new lot of reagent for serum hCG patient testing and October 6, 2018. 3. Review of the "hCG Time of Testing QuickVue+: One Step hCG Combo" log for patient test results from September and October 2018 showed serum testing was performed with lot 704249 on patient samples on September 24, September 28, October 1 and October 4, 2018. 4. Interview with the technical consultant on January 29, 2019 at 3:15 PM confirmed testing personnel did not follow the laboratory's quality control procedures when they did not test serum controls with the lot number used to perform patient serum hCG tests on four days in September and October 2018. -- 2 of 2 --

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