Memphis Childrens Clinic

CLIA Laboratory Citation Details

2
Total Citations
5
Total Deficiencyies
5
Unique D-Tags
CMS Certification Number 25D0677021
Address 7672 Airways, Southaven, MS, 38671-5304
City Southaven
State MS
Zip Code38671-5304
Phone662 349-2555
Lab DirectorHARRY PHILLIPS

Citation History (2 surveys)

Survey - January 25, 2023

Survey Type: Standard

Survey Event ID: 6PKS11

Deficiency Tags: D6049 D5429

Summary:

Summary Statement of Deficiencies D5429 MAINTENANCE AND FUNCTION CHECKS CFR(s): 493.1254(a)(1) For unmodified manufacturer's equipment, instruments, or test systems, the laboratory must perform and document maintenance as defined by the manufacturer and with at least the frequency specified by the manufacturer. This STANDARD is not met as evidenced by: Based on review of the maintenance log in the Sysmex XNL-330 User's Manual, lack of documentation from 4/15/2022 through 1/25/2023, and interview with the office manager at 12:00 p.m. on 1/25/2023, the laboratory failed to document as performed the manufacturer's required daily and weekly maintenance and reagent change information on the Sysmex XNL-330 hematology analyzer. Findings include: 1. The Sysmex XNL-330 manufacturer's requires the following maintenance be performed and documented: Daily Maintenance: a. Execute shutdown Daily QC: a. Quality Control b. Verify Background Count Weekly Maintenance: a. Run Cell Clean Auto Reagent Change: Cell Pack DCL, Lysercell WDF, Sulfolyser SLS, Fluorocell WDF 2. Interview with the Office Manager on 1/25/2023 at 12:00 p.m. confirmed maintenance was not documented as performed for the Sysmex XNL-330 hematology analyzer since instrument installation on 4/15/2022. D6049 TECHNICAL CONSULTANT RESPONSIBILITIES CFR(s): 493.1413(b)(8)(iii) The procedures for evaluation of the competency of the staff must include, but are not limited to review of intermediate test results or worksheets, quality control records, proficiency testing results, and preventive maintenance records. This STANDARD is not met as evidenced by: 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 -- Based on review of laboratory testing records to include temperature logs from 6/1 /2021 through 1/25/2023 and interview with the Office Manager at 12:00 p.m. on 1/25 /2023, the following records had not been documented as reviewed by the technical consultant (TC): Findings Include: 1. The surveyor reviewed laboratory records to include temperature logs from 6/1/2021 through 1/25/2023. There was no documented review of the following records by the technical consultant: a. Temperature logs (room, humidity and refrigerators) from 6/1/2021 through 1/25/2023 2. Interview with the Office Manager 12:00 p.m. on 1/25/2023 confirmed there was no documented review of the temperature records by the TC. -- 2 of 2 --

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Survey - November 28, 2018

Survey Type: Standard

Survey Event ID: BQOX11

Deficiency Tags: D5481 D5311 D5477

Summary:

Summary Statement of Deficiencies D5311 SPECIMEN SUBMISSION, HANDLING, AND REFERRAL CFR(s): 493.1242(a) The laboratory must establish and follow written policies and procedures for each of the following, if applicable: (1) Patient preparation. (2) Specimen collection. (3) Specimen labeling, including patient name or unique patient identifier and, when appropriate, specimen source. (4) Specimen storage and preservation. (5) Conditions for specimen transportation. (6) Specimen processing. (7) Specimen acceptability and rejection. (8) Specimen referral. This STANDARD is not met as evidenced by: Based on review of laboratory specimen collection and labeling policies, and interview with staff at 2:00 pm on the day of survey, the laboratory failed to follow the laboratory's written policy and procedure for labeling of patient specimens. The laboratory's written labeling policy requires testing personnel to label microtubes with the patient name and date of birth. Findings include: One patient specimen for a CBC was observed with no label on it. According to the staff no information was being written or attached to the patient specimen after collection. The patient's date of birth was entered into the AcT Diff hematology analyzer prior to processing and the patient's name was written on the report after printing from analyzer. This does not comply with the lab's written labeling policy. D5477 CONTROL PROCEDURES CFR(s): 493.1256(e)(4)(g) (e) For reagent, media, and supply checks, the laboratory must do the following: (e) (4) Before, or concurrent with the initial use-- (e)(4)(i) Check each batch of media for sterility if sterility is required for testing; (e)(4)(ii) Check each batch of media for its ability to support growth and, as appropriate, select or inhibit specific organisms or produce a biochemical response; and (e)(4)(iii) Document the physical characteristics 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 -- of the media when compromised and report any deterioration in the media to the manufacturer. (g) The laboratory must document all control procedures performed. This STANDARD is not met as evidenced by: Based on review of Quality Control (QC) records from last survey, 12/20/16 through day of survey, and interview with staff at 4:00 pm on 11/28/18, the laboratory failed to document the QC results for urine media (URICULT Urine Culture CLED/EMB paddle system.) Findings include: On the day of survey, review of the Urine Culture QC log indicated that the laboratory was using Escherichia coli (ATCC 25922) and Pseudomonas aeruginosa (ATCC 27853) as positive growth controls for each new batch or shipment of URICULT. On the following dates a new lot number of URICULT paddles was put into use with incomplete control results documented (sterility or colony counts). The laboratory performed approximately 285 Uricults during this time frame, January 2018 until November 2018. 1/26/18 - URICULT Uricheck lot number - 7H24A - no sterility results 4/25/18 - URICULT Uricheck lot number - 8A31A - no sterility results 8/27/18 - URICULT Uricheck lot number - 8D20A - no QC or sterility results D5481 CONTROL PROCEDURES CFR(s): 493.1256(f)(g) (f) Results of control materials must meet the laboratory's and, as applicable, the manufacturer's test system criteria for acceptability before reporting patient test results. (g) The laboratory must document all control procedures performed. This STANDARD is not met as evidenced by: Based on review of Quality control (QC) records for urine cultures from last survey, 12/20/16 through day of survey and interview with staff on 11/28/18, the laboratory reported patient results when QC was not acceptable on the URICULT Urine Culture CLED/EMB paddle system. Findings include: Review of the urine QC culture log revealed 2 organisms were used as positive controls for the URICULT CLED/EMB paddle system for each new lot number or shipment. On 4/25/18 when Lot number 8A31A was tested, Pseudomonas aeruginosa was reported as 0 colonies when it should have been positive for growth. Lot number 8A31A of URICULT CLED/EMB was put into use when the QC was not valid and patient results were reported using this lot from 4/25/18 through 8/27/18. -- 2 of 2 --

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