Pain & Rehabilitative Consultants

CLIA Laboratory Citation Details

2
Total Citations
3
Total Deficiencyies
2
Unique D-Tags
CMS Certification Number 05D1084815
Address 1335 Stanford Ave, Emeryville, CA, 94608
City Emeryville
State CA
Zip Code94608
Phone(510) 647-5101

Citation History (2 surveys)

Survey - November 19, 2025

Survey Type: Standard

Survey Event ID: 53R111

Deficiency Tags: D5217 D5791

Summary:

Summary Statement of Deficiencies 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. This STANDARD is not met as evidenced by: . Based on review of the laboratory written procedure for "PRCGM Alternative Proficiency Testing" and laboratory reports for 2023, 2024, and 2025; and interview with the Laboratory Director, it was determined that the laboratory failed to verify the accuracy of High complexity testing in Toxicology for 11-nor-9-carboxy-THC (THC metabolite), Meprobamate (Carisoprodol metabolite), Amphetamine, Methamphetamine, and O-desmethyltramadol (tramadol metabolite). Findings included: a. The laboratory implemented an alternative method procedure as an additional means for verifying the accuracy of their laboratory-developed-test utilizing LC-MS/MS (Liquid Chromatography-Tandem Mass Spectrometry methodology), as follows: "Twice a year, the 3 calibrators (CAL 0, CAL 25, CAL1000) will be run in duplicate as unknown proficiency testing samples. The results will be reviewed to ensure that no anayltes are detected in the CAL 0 and all analytes in the method are detected in both the CAL25 and CAL 1000." b. The laboratory reported unacceptable results, Not detected, for CAL25, as follows: . . . EVENT ANALYTE NOT DETECTED ---------------------------------------------------------------- 2023_A_01 THC X Meprobamate X 2023_A_02 THC X Meprobamate X Amphetamine X Methamphetamine X 2023_B_01 THC X Meprobamate X 2023_B_02 THC X Meprobamate X 2024_A_01 THC X Meprobamate X 2024_A_02 THC X Meprobamate X 2024_B_01 THC X Meprobamate X 2024_B_02 THC X Meprobamate X 2025_A_01 THC X Meprobamate X 2025_A_02 THC X Meprobamate X 2025_B_01 THC X Meprobamate X o-desmethyltramadol X Amphetamine X Methamphetamine X 2025_B_02 THC X Meprobamate X o- 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 -- desmethyltramadol X Amphetamine X Methamphetamine X c. The Laboratory Director affirmed ( 11/19/25 at 3:00 PM) the aformentioned results reported for CAL25. d. It was determined that the results reported as "Not detected" failed to meet the laboratory's criteria requiring All analytes to be Detected in the CAL25; and thus, the laboratory failed to verify the accuracy of testing. e. The reliability and quality of results reported for the aforementioned analytes during the aforementioned timeframes could not be assured during this Survey. The laboratory reported a total annual tests volume of 36,845 (CMS116 CLIA Application, 11/05/25). Laboratory reports of patients' tests results randomly selected for review are, as follows: Print Date Patient Provider ----------------------------------------- . 2/22/23 H, K Dr. BJ 8/30 /23 J, J Dr. BJ 5/28/24 M, L Dr. BJ 8/27/24 P, P Dr. BM 3/04/25 H, V Dr. BM 5/22 /25 T, T Dr. NK 8/19/25 GM, J Dr. NK . D5791 ANALYTIC SYSTEMS QUALITY ASSESSMENT CFR(s): 493.1289(a)(c) (a) The laboratory must establish and follow written policies and procedures for an ongoing mechanism to monitor, assess, and when indicated, correct problems identified in the analytic systems specified in 493.1251 through 493.1283. This STANDARD is not met as evidenced by: Based on the deficiency cited, review of a laboratory written procedure and records titled, "PRCGM Alternative Proficiency Testing Results Summary" for 2023-2025, the lack of records, and interview with the Laboratory Director, it was determined the laboratory failed in it's responsibility to the providers and patients to follow it's wriitten policy/procedure to identify testing failures, investigate, and resolve problems. Findings included: a. The laboratory written procedure for it's alternative proficiency testing program stated, as follows: 1. That All analytes are detected in the CAL 25, calibrator material used as the unknown proficiency testing sample. 2. "Any proficiency testing failures will be investigated, documented, and reviewed by the laboratory director. If necessary,

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Survey - September 1, 2022

Survey Type: Standard

Survey Event ID: 1A0F11

Deficiency Tags: D5217

Summary:

Summary Statement of Deficiencies 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. This STANDARD is not met as evidenced by: Based on observation of the ABI SCIEX, Q Trap 4500 [SN B122241308] for toxicology testing using LC-MS/MS (Liquid chromatography-tandem Mass spectrometry), review of 2020-2021 CAP "DMPM" (College of American Pathologists, Drug Monitoring for Pain Management) proficiency testing reports and laboratory reports for 49 drugs tested, and interview with the Labortory Director, it was determined that the laboratory failed to at least twice annually verify the accuracy of testing at the analyte level. Findings included: 1. The laboratory tested and reported results for 49 drugs. 2. The laboratory chose to enroll in CAP's DMPM proficiency testing program as the means to fulfill the requirement to at least twice annually verify the accuracy of testing for drugs. 3. The DMPM reports revealed the following: a. for 2020 i. 20 drugs were not present in both events ii. 16 drugs were only present in one event a. for 2021 i. 24 drugs were not present in both events ii. 23 drugs were only present in one event 4. The Laboratory Director/Technical Supervisor affirmed (8/31 /22 at 10:10AM and 9/01/22 at 3PM) the laboratory used no additional method to verify the accuracy of testing in 2020 - 2021; and thus, the laboratory failed to verify test accuracy at least twice annually for 36 out of 49 drugs in 2020, and 47 out of 49 drugs in 2021. 5. For 8 out of 8 reports selected at random from 2020- 2021, as follows, the laboratory reported results as Detected for drugs that were not verified for test accuracy at least twice annually: Date 3/10/20 5/27/20 7/27/20 11/12/20 2/25/21 3 /03/21 6/13/21 9/04/21 12/04/21 6. The reliability and quality of results reported as Detected could not be assured for the drugs the laboratory failed to verify at least twice annually. The laboratory reported 49 results per specimen tested for a total of 94,129 toxicology results annually (CLIA Application, 8/24/22). 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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