Tyler Internal Medicine Associates Pa

CLIA Laboratory Citation Details

2
Total Citations
14
Total Deficiencyies
7
Unique D-Tags
CMS Certification Number 45D0972490
Address 1910 Roseland Blvd, Tyler, TX, 75701
City Tyler
State TX
Zip Code75701
Phone903 533-0644
Lab DirectorAMY SIMPSON

Citation History (2 surveys)

Survey - August 25, 2022

Survey Type: Standard

Survey Event ID: HNXC11

Deficiency Tags: D0000 D5401 D5403 D5469 D0000 D5401 D5403 D5469

Summary:

Summary Statement of Deficiencies D0000 An onsite survey conducted from 08/24/2022 to 8/25/2022 found the laboratory in compliance with 42 CFR Part 493, Requirements for Laboratories. D5401 PROCEDURE MANUAL CFR(s): 493.1251(a) A written procedures manual for all tests, assays, and examinations performed by the laboratory must be available to, and followed by, laboratory personnel. Textbooks may supplement but not replace the laboratory's written procedures for testing or examining specimens. This STANDARD is not met as evidenced by: Based on a review of laboratory policy, reagent instructions for use, laboratory documents, and confirmed in interview, the laboratory failed to perform calibration verification, as described by the laboratory policy, for one out of six reagents, Vitamin D, reviewed meeting the designated criteria in 2021. The findings include: 1. Review of the laboratory policy titled "Laboratory Procedure Quality Control Program", section D. Calibration Verification stated: "Calibration verification is required for most tests that do not use at least (3) levels of calibration materials that challenge the limits of linearity for the test or test system." 2. Review of the Vitamin D instructions for use, section "Calibrator Contents" listed the following 2 calibrators: "1 Set of VITROS 25-OH Vitamin D Total calibrators 1 and 2". Surveyor queried on 8/24/2022 at 1435 hours for the calibration verification records for 2021 for Vitamin D and none was provided. 3. Review of the laboratory monthly usage total report from 8/1/2021 to 8/1/2022 listed the total volume of Vitamin D tests performed at 9,121. 4. In an interview on 8/24/2022 at 14:45 hours, in the conference room, the technical consultant confirmed that Vitamin-D calibration only had two levels and that calibration verification had not been performed on Vitamin-D as per the laboratory policy for 2021. 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 -- D5403 PROCEDURE MANUAL CFR(s): 493.1251(b) The procedure manual must include the following when applicable to the test procedure: (1) Requirements for patient preparation; specimen collection, labeling, storage, preservation, transportation, processing, and referral; and criteria for specimen acceptability and rejection as described in 493.1242. (2) Microscopic examination, including the detection of inadequately prepared slides. (3) Step-by-step performance of the procedure, including test calculations and interpretation of results. (4) Preparation of slides, solutions, calibrators, controls, reagents, stains, and other materials used in testing. (5) Calibration and calibration verification procedures. (6) The reportable range for test results for the test system as established or verified in 493.1253. (7) Control procedures. (8)

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Survey - November 8, 2018

Survey Type: Standard

Survey Event ID: VCL011

Deficiency Tags: D2009 D5421 D6004 D2009 D5421 D6004

Summary:

Summary Statement of Deficiencies D2009 TESTING OF PROFICIENCY TESTING SAMPLES CFR(s): 493.801(b)(1) The individual testing or examining the samples and the laboratory director must attest to the routine integration of the samples into the patient workload using the laboratory's routine methods. This STANDARD is not met as evidenced by: . Based on review of American Proficiency Institute (API) proficiency testing documentation for 2017 and 2018, confirmed by staff interview, the laboratory director failed to attest that proficiency testing was performed by routine integration of samples into the patient workload using the laboratory's routine methods or to delegate that attestation to an individual meeting the education requirements of a technical consultant for moderate complexity testing. 1. API proficiency testing documentation was reviewed. Examination of attestation forms revealed that the following were signed by testing person 1 (CMS form 209) as the laboratory director's designee: 2017 1st event--Chemistry, core 2017 1st, 2nd, 3rd events--Hematology 2017 2nd, 3rd events--Microbiology 2017 1st, 2nd, 3rd events--Immunology 2018 1st, 2nd events--Chemistry, miscellaneous 2018 1st, 2nd, 3rd events--Chemistry, core 2018 1st, 2nd events--Hematology 2018 1st, 2nd, 3rd events--Microbiology 2018 1st, 2nd events--Immunology 2. Review of laboratory employee education and training documentation revealed that testing person 1 held an associate's degree in medical laboratory technology and did not meet the educational requirements of a technical consultant for moderate complexity testing according to 42 CFR 493.1409. 3. In an interview at the site on 11-08-2018, testing person 1 stated she was not aware of the requirements regarding delegation of signatory authority for proficiency testing attestation forms. . D5421 ESTABLISHMENT AND VERIFICATION OF PERFORMANCE CFR(s): 493.1253(b)(1) 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 -- 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 performance validation documentation for the Vitros 5600 chemistry analyzer, confirmed by staff interview, the laboratory failed to verify that reference ranges for chemistry testing were appropriate for the patient population served. Findings: 1. Validation studies for the Vitros 5600 chemistry analyzer, put in service in August 2017, were reviewed. No documentation of studies for the verification of reference ranges was found. 2. In an interview at the site on 11-08- 2018, testing person 1 stated that the reference ranges in use had been established previously using a different platform and to her knowledge no validation data had been analyzed to verify the appropriateness of the ranges using the Vitros analyzer. . D6004 LABORATORY DIRECTOR RESPONSIBILITIES CFR(s): 493.1407(a)(b) The laboratory director is responsible for the overall operation and administration of the laboratory, including the employment of personnel who are competent to perform test procedures, and record and report test results promptly, accurate, and proficiently and for assuring compliance with the applicable regulations. (a) The laboratory director, if qualified, may perform the duties of the technical consultant, clinical consultant, and testing personnel, or delegate these responsibilities to personnel meeting the qualifications of 493.1409, 493.1415, and 493.1421, respectively. (b) If the laboratory director reapportions performance of his or her responsibilities, he or she remains responsible for ensuring that all duties are properly performed. This STANDARD is not met as evidenced by: . Based on review of laboratory testing personnel competency verification documentation for 2017 and 2018, confirmed by staff interview, the laboratory director failed to delegate the responsibility to verify the competency of testing personnel to a qualified technical consultant. Findings: 1. Competency verification documentation was reviewed. Examination of the Laboratory Competency Assessment Checklists for testing personnel revealed that the forms were signed by "evaluators" as follows: Testing person 1-2018 annual--signed by testing person 2 Testing person 2-2017 and 2018 annual--signed by testing person 1 Testing person 3- 2017 6-month--signed by testing person 1 Testing person 4-2017 annual--signed by testing person 1 Testing person 5-2018 annual--signed by testing person 1 2. Review of laboratory employee education and training documentation revealed that testing person 1 held an associate's degree in medical laboratory technology and did not meet the educational requirements of a technical consultant for moderate complexity testing according to 42 CFR 493.1409. 3. In an interview at the site on 11-08-2018, testing person 1 stated she was unaware of the of the requirements regarding delegation of authority for testing personnel competency verification. . -- 2 of 2 --

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