Southwest Medical Center

CLIA Laboratory Citation Details

4
Total Citations
30
Total Deficiencyies
16
Unique D-Tags
CMS Certification Number 39D0179861
Address 119 Wilson Road, Bentleyville, PA, 15314-1027
City Bentleyville
State PA
Zip Code15314-1027
Phone724 239-4700
Lab DirectorKAMLESH GOSAI

Citation History (4 surveys)

Survey - August 7, 2025

Survey Type: Standard

Survey Event ID: 1C1511

Deficiency Tags: D5413 D5413

Summary:

Summary Statement of Deficiencies D5413 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT CFR(s): 493.1252(b) (b) The laboratory must define criteria for those conditions that are essential for proper storage of reagents and specimens, accurate and reliable test system operation, and test result reporting. The criteria must be consistent with the manufacturer's instructions, if provided. These conditions must be monitored and documented and, if applicable, include the following: (b)(1) Water quality. (b)(2) Temperature. (b)(3) Humidity. (b)(4) Protection of equipment and instruments from fluctuations and interruptions in electrical current that adversely affect patient test results and test reports. This STANDARD is not met as evidenced by: Based on review of the laboratory's temperature records and interview with the Medical Technologist (MT), the laboratory failed to monitor and document to ensure the proper storage of reagents was met for 1 of 1 Quidel Ortho Vitros XT3400 (chemistry), 1 of 1 Quidel OrthoVitro ECiQ (immunology), and 1 of 1 Abbott Cell- Dyn Emerald (hematology) analyzers from 09/14/2023 to 08/07/2025. Findings Include: 1. On the date of the survey, 08/07/2024 at 1:00 pm, review of the laboratory's temperature control logs revealed the laboratory failed to monitor and document freezer (acceptable range: 0- -23 degrees Celsius) and refrigerator temperatures (acceptable ranges 2-10 degrees Celsius) on weekends and holidays to ensure the proper storage of reagents was met for 1 of 1 QuidelOrtho Vitros XT3400, 1 of 1 Quidel OrthoVitros ECiQ and 1 of 1 Abbott Cell-Dyn Emerald analyzers from 09/14/2023 to 08/07/2025). 2. The laboratory performed 127,170; microbiology, chemistry and hematology tests in 2024 (CMS 116, estimated annual volume, dated 07 /25/2025. 3. The TC confirmed the above findings on 11/13/2024 at 11:00 am. 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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Survey - September 14, 2023

Survey Type: Standard

Survey Event ID: EJ3L11

Deficiency Tags: D5421 D6053 D5211 D3009 D6054 D5215 D5421 D6053 D6054

Summary:

Summary Statement of Deficiencies D3009 FACILITIES CFR(s): 493.1101(c) The laboratory must be in compliance with applicable Federal, State, and local laboratory requirements. This STANDARD is not met as evidenced by: Based on surveyor record review and interview with the Testing Personnel #1 (TP) (CMS 209 personnel #2), the laboratory failed to ensure that the State of Pennsylvania (PA) regulations were met regarding having a supervisor on site during all normal scheduled working hours in which microbiology, chemistry and hematology tests were performed from 09/13/2021 to the date of the survey. Findings include: 1. The PA regulations (5.23 (b)(1)) states: "A general supervisor who meets all the requirements of subsection (a)(1), (2) or (3) and is on the laboratory premises during all normal scheduled working hours in which tests are being performed." 2. The laboratory performs patient testing Monday through Friday from 08:00 am to 05:00 pm according to the information in the CMS-116 form. 3. Review of the laboratory personnel report (Pennsylvania State) form on 09/14/2023 showed that the laboratory director (LD) acts as the only general supervisor for the laboratory. The LD directs one other laboratory. 4. On the day of the survey, 09/14/2023 at 09:01 am, during an interview, the TP#1 stated that the laboratory did not have a qualified supervisor onsite for every hour of patient testing according to chapter 5 section 5.23 of the Pennsylvania State regulations for clinical laboratories. D5211 EVALUATION OF PROFICIENCY TESTING PERFORMANCE CFR(s): 493.1236(a) The laboratory must review and evaluate the results obtained on proficiency testing performed as specified in subpart H 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 American Association of Bioanalysts Medical Laboratory Evaluation (AAB-MLE) proficiency testing (PT) records and interview with the Testing Personnel #1 (TP) (CMS 209 personnel #2), the Laboratory Director failed to ensure 1 of 1 chemistry PT results and 3 of 3 hematology PT results were reviewed and

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Survey - September 13, 2021

Survey Type: Standard

Survey Event ID: CYVY11

Deficiency Tags: D5439 D5781 D6021 D6063 D6065 D6065 D5209 D5407 D5421 D5433 D5439 D5781 D6021 D6063

Summary:

Summary Statement of Deficiencies 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 the clinical staff competency assessment (CA) policy and interview with testing personnel (TP) #1, the laboratory failed to follow their written procedure to assess the competency 1 of 2 (TP) for each individual test system they performed in 2021. Findings include: 1. The clinical staff competency assessment policy, point #2 states, "Competency assessment must be assessed a minimum of twice in the first year of employment of testing personnel and annually there after". 2. On the day of survey, 09/13/2021, the laboratory was unable to provide CA records for the first year of employment for 1 of 2 TP (TP#1 started testing on 08/27/2020), for each test system performed in the departments of Clinical chemistry, Hematology, immunology and Virology in 2021. 3. The TP# 1 confirmed the findings above on 09 /13/2021 around 12:05 pm. 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 laboratory policies and interview with testing personnel (TP)#1, the laboratory failed to have all laboratory procedures signed and dated by the current Statement of Deficiencies (X1) Provider/Supplier/CLIA Identification Number (X3) Date Survey Completed Name of Provider or Supplier Street Address, City, State -- 1 of 5 -- laboratory director (LD) from 09/13/2019 to 09/13/2021. Findings include: 1. On the day of survey, 09/13/2021, a review of a sampling of the laboratory procedures, revealed the laboratory procedures in use were not signed by the LD. 2. TP# 1 confirmed the findings above on 09/13/2021 around 2:05 pm. D5421 ESTABLISHMENT AND VERIFICATION OF PERFORMANCE CFR(s): 493.1253(b)(1) Each laboratory that introduces an unmodified, FDA-cleared or approved test system must do the following before reporting patient test results: (1)(i) Demonstrate that it can obtain performance specifications comparable to those established by the manufacturer for the following performance characteristics: (1)(i)(A) Accuracy. (1)(i) (B) Precision. (1)(i)(C) Reportable range of test results for the test system. (1)(ii) Verify that the manufacturer's reference intervals (normal values) are appropriate for the laboratory's patient population. This STANDARD is not met as evidenced by: Based on review of the laboratory records, lack of documentation and interview with testing personnel (TP) #1, the laboratory failed to demonstrate and document verification of performance specifications for accuracy and precision on the Ortho Clinical Diagnostics Vitros-ECiQ for Covid-19 antibody testing before reporting patient test results in 2020. Findings Include: 1. On the days of survey 09/13/2021, the laboratory could not provide verification of performance specifications for accuracy and precision activities performed on the Ortho Clinical Diagnostics Vitros-ECiQ for Covid-19 testing before reporting patient test result in 2020. 2. TP# 1 confirmed the finding above on 09/13/2021 around 1:00 p.m. D5433 MAINTENANCE AND FUNCTION CHECKS CFR(s): 493.1254(b)(1) 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 establish a maintenance protocol that ensures equipment, instrument, and test system performance that is necessary for accurate and reliable test results and test result reporting. The laboratory must perform and document the maintenance activities specified in paragraph (b)(1)(i) of this section. This STANDARD is not met as evidenced by: Based on observation of the laboratory, lack of documentation and interview with testing personnel (TP) #1, the laboratory failed to establish a maintenance policy to assess the maintenance/function of 3 of 3 thermometers used to monitor the laboratory room, freezer and refrigerator temperatures and 4 of 4 Thermo Scientific Finnpipettes in use on 08/13/2021. Findings Include: 1. On the day of survey, 09/13/2021, observation of the laboratory revealed, the following thermometers and mechanical pipettes in use in the laboratory on 09/13/2021: 4 of 4 Thermo Scientific Finnpipettes: 2 ml Fixed Volume. 100 -1000 micro liter. 3 ml Fixed Volume. 5 ml Fixed Volume. 3 of 3 unlabeled thermometers 2. The laboratory could not provide a maintenance policy for the thermometers and pipettes. 3. The laboratory could not provide -- 2 of 5 -- purchase records or previous maintenance/function check records performed on the thermometers and pipettes. 4. TP#1 confirmed the findings above on 09/13/2021 around 02:50 pm. D5439 CALIBRATION AND CALIBRATION VERIFICATION CFR(s): 493.1255(b) Unless otherwise specified in this subpart, for each applicable test system the laboratory must do the following: Perform and document calibration verification procedure - (b)(1) Following the manufacturer's calibration verification instructions; (b)(2) Using the criteria verified or established by the laboratory under 493.1253(b)(3) -- (b)(2)(i) Including the number, type, and concentration of the materials, as well as acceptable limits for calibration verification; and (b)(2)(ii) Including at least a minimal (or zero) value, a mid-point value, and a maximum value near the upper limit of the range to verify the laboratory's reportable range of test results for the test system; and (b)(3) At least once every 6 months and whenever any of the following occur: (b)(3)(i) A complete change of reagents for a procedure is introduced, unless the laboratory can demonstrate that changing reagent lot numbers does not affect the range used to report patient test results, and control values are not adversely affected by reagent lot number changes. (b)(3)(ii) There is major preventive maintenance or replacement of critical parts that may influence test performance. (b)(3)(iii) Control materials reflect an unusual trend or shift, or are outside of the laboratory's acceptable limits, and other means of assessing and correcting unacceptable control values fail to identify and correct the problem. (b)(3)(iv) The laboratory's established schedule for verifying the reportable range for patient test results requires more frequent calibration verification. This STANDARD is not met as evidenced by: Based on calibration verification records and interview with testing personnel (TP) #1, the laboratory failed to perform calibration verification on the Ortho Clinical Diagnostics Vitros-ECiQ for Vitamin D, Vitamin B and Covid-19 twice annually in 2020 and 2021. Findings Include: 1. On the day of survey, 09/13/2021, a review of calibration verification records revealed, the laboratory did not perform calibration verification on the Ortho Clinical Diagnostics Vitros-ECiQ for Vitamin D, Vitamin B and Covid-19 at least twice annually in 2020 and 2021. 2. TP#1 confirmed the finding above on 09/13/2021 around 02:00 pm. D5781

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Survey - March 26, 2019

Survey Type: Standard

Survey Event ID: MZRE11

Deficiency Tags: D5429 D5439 D5439 D6053 D6053

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 instrument maintenance records, and interview with testing personnel (TP) #1, the laboratory failed to follow the maintenance protocol and document maintenance activities on 1 of 1 Mechanical (serial # 18162094) 1 Channel, 1-10 milliliter Pipette, used to prepare controls for the Cobas Integra 400 plus from 2018 to the date of survey. Finding Include: 1. The Mechanical (serial # 18162094) 1 Channel, 1-10 milliliter Pipette maintenance document states under notes " Check the performance of your pipettor regularly e.g. every 3 months and always after in house service maintenance". 1. On the day of survey, 03/26/2019, TP could not provide maintenance records for 1 of 1 Mechanical (serial # 18162094) one Channel, 1-10 milliliter Pipette, which was last calibrated on 03/06/2018. 2. TP#1 confirmed the finding above on 03/26/2019 around 1:30 pm. D5439 CALIBRATION AND CALIBRATION VERIFICATION CFR(s): 493.1255(b) Unless otherwise specified in this subpart, for each applicable test system the laboratory must do the following: Perform and document calibration verification procedure - (b)(1) Following the manufacturer's calibration verification instructions; (b)(2) Using the criteria verified or established by the laboratory under 493.1253(b)(3) -- (b)(2)(i) Including the number, type, and concentration of the materials, as well as acceptable limits for calibration verification; and (b)(2)(ii) Including at least a minimal (or zero) value, a mid-point value, and a maximum value near the upper limit 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 range to verify the laboratory's reportable range of test results for the test system; and (b)(3) At least once every 6 months and whenever any of the following occur: (b)(3)(i) A complete change of reagents for a procedure is introduced, unless the laboratory can demonstrate that changing reagent lot numbers does not affect the range used to report patient test results, and control values are not adversely affected by reagent lot number changes. (b)(3)(ii) There is major preventive maintenance or replacement of critical parts that may influence test performance. (b)(3)(iii) Control materials reflect an unusual trend or shift, or are outside of the laboratory's acceptable limits, and other means of assessing and correcting unacceptable control values fail to identify and correct the problem. (b)(3)(iv) The laboratory's established schedule for verifying the reportable range for patient test results requires more frequent calibration verification. This STANDARD is not met as evidenced by: Based on review of the Cobas Integra 400 plus calibration and quality control records and interview the testing personnel (TP) #1, the laboratory failed to perform calibration verification on the Cobas Integra 400 Plus analyzer at least once every 6 months from 2018 to the day of survey. Finding Include: 1. On the day of survey, 03 /27/2019, the laboratory did not perform calibration verification at least once every 6 months on the Cobas Integra 400 Plus analyzer in 2018 and 2019. 2. The laboratory performed 20,484 patient tests on the Cobas Integra 400 Plus analyzer in 2018. 3. The laboratory performed 1,507 patient tests on the Cobas Integra 400 Plus analyzer in 2019. 4. TP#1 confirmed the findings above on 03/26/2019 around 3:10 pm. D6053 TECHNICAL CONSULTANT RESPONSIBILITIES CFR(s): 493.1413(b)(9) The technical consultant is responsible for evaluating and documenting the performance of individuals responsible for moderate complexity testing at least semiannually during the first year the individual tests patient specimens. This STANDARD is not met as evidenced by: Based on review of testing personnel (TP) records and interview the TP#1, the technical consultant (Laboratory director) failed to assess the competency of 1 of 1 TP for moderate complexity testing at least semiannually during the first year the individual analyzed Chemistry and Hematology specimen in 2018. Finding Include: 1. On the day of survey, 03/26/2019, review of personnel records revealed 1 of 1 TP was never assessed for competency before the individual started patient testing in 2018. 2. The laboratory director on 03/26/2019 around 3:30 pm confirmed TP was hired 1/25 /2018 and trained on 03/2018, but their competency was never assessed. -- 2 of 2 --

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