Florida Medical Clinic Pa

CLIA Laboratory Citation Details

2
Total Citations
5
Total Deficiencyies
4
Unique D-Tags
CMS Certification Number 10D2039980
Address 2100 Via Bella Blvd Ste 101, Land O Lakes, FL, 34639
City Land O Lakes
State FL
Zip Code34639
Phone813 778-0414
Lab DirectorMICHAEL MONTUNO

Citation History (2 surveys)

Survey - March 29, 2024

Survey Type: Standard

Survey Event ID: I4HA11

Deficiency Tags: D0000 D5417 D5219

Summary:

Summary Statement of Deficiencies D0000 An announced CLIA recertification survey was conducted at Florida Medical Clinic, LLC on 3/29/24. The laboratory is not in compliance with 42 CFR Part 493, Requirements for Laboratories. The following is a description of the standard level deficiencies: D5219 EVALUATION OF PROFICIENCY TESTING PERFORMANCE CFR(s): 493.1236(c)(2) At least twice annually, the laboratory must verify the accuracy of any test or procedure listed in subpart I of this part for which compatible proficiency testing samples are not offered by a CMS-approved proficiency testing program. This STANDARD is not met as evidenced by: Based on record review and interview with Testing Personnel (TP) #A, the laboratory failed to perform biannual verification of Mohs slide interpretation for 2 of 2 events in 2023. Findings included: -Review of proficiency test records revealed the TP forwarded representative cases from 3/31/23; 6/30/23; 9/30/23; and 12/31/23 to a secondary reviewer to verify initial diagnosis. The secondary reviewer verified all cases on 2/6/24. -Interview with the TP on 3/29/24 at 10:45 a.m. confirmed that the representative cases from 3/31/23; 6/30/23; 9/30/23; and 12/31/23 were sent to the secondary reviewer some time in 2023, but the secondary reviewer did not verify the cases until 2/6/24. 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. 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 observation, interview with the Mohs Technician, and review of the laboratory's Quality Control (QC) procedures, the laboratory failed to discard 4 of 4 Avantik inking reagents within the manufacturer's expiration date. Findings included: - On 3/29/24 at 9:45 a.m., expired Avantik inking reagents were observed in the cabinet above the counter where tissue from Mohs procedures are processed. -During an interview with the Mohs Technician on 3/29/24 at 9:49 a.m., the Mohs Technician stated that the observed Avantik inking reagents were poured off into smaller containers for use in inking tissue obtained from Mohs procedures. -Review of the laboratory's QC policy revealed that the laboratory must discard all outdated materials. -- 2 of 2 --

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Survey - September 16, 2019

Survey Type: Standard

Survey Event ID: Z4TR11

Deficiency Tags: D3011 D0000

Summary:

Summary Statement of Deficiencies D0000 An announced CLIA recertification survey was conducted at Florida Medical Clinic PA on 09/16/19. The laboratory is not in compliance with 42 CFR Part 493, Requirements for Laboratories. The following is a description of the standard level deficiencies: D3011 FACILITIES CFR(s): 493.1101(d) Safety procedures must be established, accessible, and observed to ensure protection from physical, chemical, biochemical, and electrical hazards, and biohazardous materials. This STANDARD is not met as evidenced by: Based on observation and interview with the Lab Manager the laboratory failed to dispose of Reagent Alcohol, Eosin, and Xylene substitute per the manufacturers' instructions for at least 2 of 2 years reviewed (2017-2019). Findings Included: During a tour of the laboratory on 09/16/19 at 12:00 PM it was observed that there wasn't a chemical waste container. Review of the Reagent Alcohol (Lot-377157) label revealed to "Dispose of contents/container to an approved waste disposal plant." Photographic evidence was obtained. Review of the Alcoholic Eosin Y 515 (Lot- 041218) label revealed to "Dispose of container contents to approved disposal site in accordance with local and national regulations." Photographic evidence was obtained. Review of the Xylene Substitute (Lot-481382) label revealed to "Dispose of contents /container to an approved waste disposal plant." Photographic evidence was obtained. Interview with the Lab Manager on 09/16/19 at 12:40 PM revealed that the 3 chemicals (Reagent Alcohol, Eosin, and Xylene substitute) were washed down the drain and not taken to a waste disposal plant. 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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