Doctors Pain Management Associates

CLIA Laboratory Citation Details

2
Total Citations
8
Total Deficiencyies
7
Unique D-Tags
CMS Certification Number 10D1093125
Address 825 E Oak St, Kissimmee, FL, 34744
City Kissimmee
State FL
Zip Code34744
Phone(321) 442-8009

Citation History (2 surveys)

Survey - July 7, 2020

Survey Type: Standard

Survey Event ID: 3F6N11

Deficiency Tags: D5435 D0000 D5805

Summary:

Summary Statement of Deficiencies D0000 An initial certification survey was conducted on July 7, 2020. Doctors Pain Management Associates clinical laboratory was not in compliance with 42 CFR 493, requirements for clinical laboratories. D5435 MAINTENANCE AND FUNCTION CHECKS CFR(s): 493.1254(b)(2) For equipment, instruments, or test systems developed in-house, commercially available and modified by the laboratory, or maintenance and function check protocols are not provided by the manufacturer, the laboratory must: (i) Define a function check protocol that ensures equipment, instrument, and test system performance that is necessary for accurate and reliable test results and test result reporting. (ii) Perform and document the function checks, including background or baseline checks, specified in paragraph (b)(2)(i) of this section. Function checks must be within the laboratory's established limits before patient testing is conducted. This STANDARD is not met as evidenced by: Based on record review and interview, the laboratory failed to perform function checks to validate the speed and time on their centrifuge from 3/2/20 to 7/7/20. Findings: Review of the maintenance logs showed there was no record of the laboratory's validation of the Southwest Science SC1024 centrifuge for speed and time. The laboratory used the centrifuge to spin patient samples at 10.5 G (Gauss) for 8 minutes . During an interview on 7/7/20 at 11:07 AM, the Technical Supervisor stated they had not performed validations on their centrifuge. D5805 TEST REPORT CFR(s): 493.1291(c) The test report must indicate the following: (c)(1) For positive patient identification, either the patient's name and identification number, or a unique patient identifier and 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 -- identification number. (c)(2) The name and address of the laboratory location where the test was performed. (c)(3) The test report date. (c)(4) The test performed. (c)(5) Specimen source, when appropriate. (c)(6) The test result and, if applicable, the units of measurement or interpretation, or both. (c)(7) Any information regarding the condition and disposition of specimens that do not meet the laboratory's criteria for acceptability. This STANDARD is not met as evidenced by: Based on record review and interview, the laboratory's Lab Report failed to list all the required information from 3/2/20 to 7/7/20. Findings: 1. Review of the toxicology Lab Report showed address of the location where the testing was done and the units of measurement for the test results for 4 out of 4 patients (#1, 2, 3, 4) test results. The laboratory's quantitative test results were measured in ng/ml (nanograms per milliliter). The Clinical Laboratory Improvement Amendments (CLIA) Application for Certificate signed and dated by the laboratory director on 7/7/19 noted the total estimated annual test volume was 244,800. During an interview on 7/7/20 at 2:49 PM, the Technical Supervisor stated that the address of the laboratory and the units of measurements were not on the Lab Report. 2. Review of the toxicology Lab Report showed that for 3 (#1, 3, 4) out of 4 patients, the quantitative test results were above the laboratories reportable range. The reportable range for norfentanyl was 4 - 900 ng /ml and patient #1's norfentanyl tests results were reported as 2452.54. The reportable range for hydromorphone was 20 - 4500 ng/ml and patient #3's hydromorphone tests results were reported as 40,451.03. The reportable range for oxycodone was 20 - 4500 ng/ml and patient #4's oxycodone tests results were reported as 4534.54. Test results for patient #1 should have been reported as it was greater than 900 ng/ml. Test results for patient #3 and #4 should have been reported as they were greater than 4500 ng/ml. The Clinical Laboratory Improvement Amendments (CLIA) Application for Certificate signed and dated by the laboratory director on 7/7/19 noted the total estimated annual test volume was 244,800. During an interview on 7/7/20 at 2:36 PM, the Technical Supervisor stated that the laboratory was reporting quantitative results outside the range of the reportable ranges. -- 2 of 2 --

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Survey - December 16, 2019

Survey Type: Complaint

Survey Event ID: 7R9Y11

Deficiency Tags: D5209 D5221 D0000 D5217 D5407

Summary:

Summary Statement of Deficiencies D0000 Unannounced Complaint Investigation #2019017812 was conducted on 12/16/19. Doctors Pain Management Associates was not in compliance with 42 CFR 493, requirements for clinical laboratories. D5209 PERSONNEL COMPETENCY ASSESSMENT POLICIES CFR(s): 493.1235 As specified in the personnel requirements in subpart M, the laboratory must establish and follow written policies and procedures to assess employee and, if applicable, consultant competency. This STANDARD is not met as evidenced by: Based on review of personnel files and interview with the Laboratory Director, the laboratory failed to perform competency evaluations on the Technical Supervisor or the Testing Person since high complexity Toxicology testing began on 5/21/18. Findings: The competency policy, not signed by the Laboratory Director, read, "New personnel are assessed initially during training, at 6 months, and at least annually thereafter by the Laboratory Director or designee....Personnel who have not been assessed to perform a specific test or to operate a specific instrument are not allowed to use the test/instrument to report clinical results." The personnel files did not reveal any competency evaluations performed on the Technical Supervisor or Testing person since high complexity testing began on 05/21/18. Interview with the Laboratory Director on 12/16/19 at 6:27 PM confirmed that there competencies were not performed. D5217 EVALUATION OF PROFICIENCY TESTING PERFORMANCE CFR(s): 493.1236(c)(1) At least twice annually, the laboratory must verify the accuracy of any test or procedure it performs that is not included in subpart I of this part. Statement of Deficiencies (X1) Provider/Supplier/CLIA Identification Number (X3) Date Survey Completed Name of Provider or Supplier Street Address, City, State -- 1 of 3 -- This STANDARD is not met as evidenced by: Based on review of the College of American Pathologist (CAP) proficiency testing (PT) and interview, the laboratory failed to perform and provide documentation to verify the accuracy of the testing methods for 10 out of 62 analytes tested in urine toxicology from 5/21/18 to 12/13/19, at least twice annually. Findings: Review of the College of American Pathologist (CAP) proficiency testing (PT) showed that 10 analytes were not included in CAP's test menu. The following 10 analytes were not included in CAP's test menu: Ethyl Sulfate, Midazolam, Mitragynine, Naloxone, Naltrexone, N-desmethyl Tapentadol, Norhydrocodone, Ritalinic Acid, Secobarbital, and Tapentado. The laboratory performed Split Testing on 4/19/19 that included the following 4 analytes: Ethyl Sulfate, Norhydrocodone, Secobarbital, and Tapentado. No Split Testing could be located on the following 6 analytes: Midazolam, Mitragynine, Naloxone, Naltrexone, N-desmethyl Tapentadol, and Ritalinic Acid. The laboratory started high complexity testing of toxicology analytes on 5/21/19 and stopped testing on 12/13/19. Split Testing was performed only once between 5/21/18 and 12/13/19. During an interview on 12/16/19 at 4:44 PM, the Testing Personnel confirmed that the Split Testing was performed only once. D5221 EVALUATION OF PROFICIENCY TESTING PERFORMANCE CFR(s): 493.1236(d) All proficiency testing evaluation and verification activities must be documented. This STANDARD is not met as evidenced by: Based on Medical Laboratory Evaluation (MLE) proficiency testing (PT) record review and the College of American Pathologists (CAP) proficiency testing (PT) records and interview, the laboratory failed to document proficiency evaluation for the 3rd event in 2017, and verification activities for the 2nd and 3rd events in 2018, and the 1st, 2nd, and 3rd events in 2019. Findings: 1. Review of the Medical Laboratory Evaluation (MLE) proficiency testing (PT) records for the 2017 3rd event showed that there was no documentation of the evaluation of the PT results. During an interview on 12/16/19 at 7:39 PM, the Laboratory Director acknowledged he did not know where the proficiency testing review form was located. 2. Review of for showed that the Laboratory Director failed to verify that PT samples were run in the same manner as patients by signing the attestation statement. Attestation statements were not signed by the Laboratory Director for 2nd, and 3rd events in 2018, and the 1st, 2nd and 3rd events in 2019. During an interview on 12/16/19 at 11:45 AM, the Testing Personnel acknowledged that the attestation forms were not signed by the laboratory director. D5407 PROCEDURE MANUAL CFR(s): 493.1251(d) Procedures and changes in procedures must be approved, signed, and dated by the current laboratory director before use. This STANDARD is not met as evidenced by: Based on review of the moderate complex testing procedures review, the moderate complex testing procedures and the high complexity testing procedure, and interview with the Laboratory Director, the Laboratory Director did not sign any policies or -- 2 of 3 -- procedures since he became Laboratory Director in 2016. Findings: Review of policies and procedures revealed that the Laboratory Director will approve all new policies and review them every 2 years. Review of the moderate complex testing procedures revealed a signature from the former Laboratory Director in 2015, but no signature of the current Laboratory Director when he took over in 2016. Review of the high complexity testing procedure (began 05/21/18) revealed no signature of the Laboratory Director as reviewed. Interview on 12/16/19 at 6:31 PM the Laboratory Director revealed that he started as Laboratory Director in 2016 (he could not recall specific date) and confirmed that he did not sign the policies as reviewed. -- 3 of 3 --

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