Aurora Medical Group

CLIA Laboratory Citation Details

2
Total Citations
5
Total Deficiencyies
3
Unique D-Tags
CMS Certification Number 52D0918686
Address 9200 W Loomis Rd, Franklin, WI, 53132
City Franklin
State WI
Zip Code53132
Phone(414) 529-9200

Citation History (2 surveys)

Survey - February 10, 2022

Survey Type: Standard

Survey Event ID: DLXL11

Deficiency Tags: D3031 D5437 D3031 D5437

Summary:

Summary Statement of Deficiencies D3031 RETENTION REQUIREMENTS CFR(s): 493.1105(a)(3) Analytic systems records. Retain quality control and patient test records (including instrument printouts, if applicable) and records documenting all analytic systems activities specified in 493.1252 through 493.1289 for at least 2 years. This STANDARD is not met as evidenced by: Based on surveyor review of laboratory records and interview with a technical consultant, the laboratory did not retain records showing when each lot number of Innovance D dimer reagent was used for patient testing. Findings include: 1. Review of laboratory records showed no evidence the laboratory retained the lot number and date of use for the Innovance D Dimer reagents. 2. Interview with a technical consultant (staff A) on February 10, 2022 at 12:05 PM confirmed the laboratory did not retain the dates each lot number of Innovance D Dimer reagents was put in use for patient 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 laboratory records and interview with a technical consultant, the laboratory did not ensure calibrations were performed for the Innovance D dimer assay within six months after the August 17, 2020 calibration as required by the manufacturer. The laboratory tested 37 patients between February 20 and June 9, 2021 using the expired calibration from August 17, 2020. Findings include: 1. Review of calibration records for the Innovance D dimer assay on the Sysmex CA-660 coagulation analyzer showed a calibration was completed on August 17, 2020. The next calibration record was dated June 10, 2021. The calibration record for June 10, 2021 is not complete; the record does not show evaluation of the patient comparison and is not signed or dated by the technologist or approver. 2. Review of patient testing logs from February 20 through June 9, 2021 showed the following patient testing was performed: February 20 - 28, 5 patients March, 15 patients April, 7 patients May, 7 patients June 1 - 9, 3 patients 3. Interview with a technical consultant (staff A) on February 10, 2022 at 12:05 PM confirmed calibration for the Innovance D dimer assay is required every six months and confirmed the calibration was not completed as required after the August 17, 2020 calibration. -- 2 of 2 --

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Survey - February 18, 2020

Survey Type: Standard

Survey Event ID: QF0K11

Deficiency Tags: D5545

Summary:

Summary Statement of Deficiencies D5545 HEMATOLOGY CFR(s): 493.1269(b)(d) (b) For all nonmanual coagulation test systems, the laboratory must include two levels of control material each 8 hours of operation and each time a reagent is changed. (d) The laboratory must document all control procedures performed, as specified in this section. This STANDARD is not met as evidenced by: Based on surveyor review of Siemens CA-660 coagulation analyzer printouts and interview with the technical consultant, the laboratory did not perform quality control (QC) each eight hours of operation on the coagulation analyzer on two days from December 19 through December 27, 2019. Findings include: 1. Review of Siemens CA-660 printout revealed: On December 19, 2019, QC was performed at 9:57 AM, Patient 1 and Patient 2 testing performed at 6:12 PM and Patient 3 testing performed at 6:13 PM. No additional QC was performed between the two times. On December 26, 2019, QC was performed at 10:24 AM, Patient 4 testing performed at 7:02 PM. No additional QC was performed between the two times. 2. Interview with the technical consultant on February 18, 2020 at 11:15 AM confirmed the laboratory did not perform quality control each eight hours of operation prior to patient testing on the Siemens CA-660 coagulation analyzer. 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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