Upstate Dermatology Pc

CLIA Laboratory Citation Details

2
Total Citations
11
Total Deficiencyies
5
Unique D-Tags
CMS Certification Number 33D0693098
Address 461 Clinton Street Ext, Suite 1, Schenectady, NY, 12305
City Schenectady
State NY
Zip Code12305
Phone(518) 374-7222

Citation History (2 surveys)

Survey - December 2, 2025

Survey Type: Standard

Survey Event ID: WQ8U11

Deficiency Tags: D5411 D5417 D5411 D5417

Summary:

Summary Statement of Deficiencies D5411 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT CFR(s): 493.1252(a) (a) Test systems must be selected by the laboratory. The testing must be performed following the manufacturer's instructions and in a manner that provides test results within the laboratory's stated performance specifications for each test system as determined under 493.1253. This STANDARD is not met as evidenced by: Based on direct observations, review of the Material Safety Data Sheets (MSDS), reagent manufacturer's storage requirements, as well as interview with the Testing Person (TP), the laboratory failed to properly store flammable reagents in the Mohs processing laboratory as required by the MSDS. FINDINGS: 1. The surveyor's observations in the Mohs processing laboratory confirmed on December 2, 2025, at approximately 9:30 A.M., the following reagents and processing materials were not properly stored in the flammable materials storage cabinet as required by the MSDS and the manufacturer's storage requirements: a. Avantik Acetone, lot: 2426703, expiration: September 30, 2027, stored in a cabinet beneath the sink in the Mohs processing laboratory inside a purple "Pearson Prentice Hall" canvas bag. b. Avantik Eosin Working Solution, lot: 43090129, expiration September 19, 2025, stored in a cabinet beneath the sink in the Mohs processing laboratory inside a plastic bag. 2. The TP confirmed the findings on December 2, 2025, at approximately 12:00 P.M. D5417 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT CFR(s): 493.1252(d) (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 direct observations, review of Standard Operating Procedures (SOPs), as well as interview with the TP, the laboratory failed to remove from inventory expired reagents, solutions, and testing supplies utilized for patient specimen processing. FINDINGS: 1. The surveyor's observations in the Mohs laboratory confirmed on December 2, 2025, at approximately 9:00 A.M., the following reagents and processing materials were not removed from inventory: a. Avantik Tissue Marking Dye Red, lot: 183621, expiration: October 31, 2025, stored under the fume hood in the Mohs processing laboratory. b. Avantik Eosin Working Solution, lot: 43090129, expiration: September 19, 2025, stored in the Justrite flammable liquid storage cabinet in the Mohs processing laboratory. c. Avantik Xylene, lot: AX011, expiration October 2019, stored in the Justrite flammable liquid storage cabinet in the Mohs processing laboratory. d. Avantik Xylene, lot: 2211911, expiration: May 4, 2025, stored in the Justrite flammable liquid storage cabinet in the Mohs processing laboratory. 2. This was contrary to instructions indicated in the current, approved SOPs for removal of expired reagents from inventory. 3. The TP stated the expired Avantik Tissue Marking Dye Red and expired Avantik Eosin Working Solution were utilized for patient specimen processing. Ninety-seven patient specimens were processed using the expired Avantik Tissue Marking Dye Red and 171 patient specimens were processed using the expired Avantik Eosin Working Solution. 4. The TP informed the surveyor that the expired Avantik Xylene was not utilized for patient specimen processing. 5. The TP confirmed the findings on December 2, 2025, at approximately 12:00 P.M. -- 2 of 2 --

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Survey - May 23, 2023

Survey Type: Standard

Survey Event ID: QHDJ11

Deficiency Tags: D3013 D5403 D5411 D5413 D5403 D5411 D5413

Summary:

Summary Statement of Deficiencies D3013 FACILITIES CFR(s): 493.1101(e) Records and, as applicable, slides, blocks, and tissues must be maintained and stored under conditions that ensure proper preservation. This STANDARD is not met as evidenced by: Based on direct observations of the Mohs slides and an interview with the general supervisor, the laboratory failed to properly store Mohs slides to ensure preservation. FINDINGS: 1. The general supervisor confirmed on May 23, 2023, at approximately 10:15 A.M. the surveyor's findings that the laboratory stored Mohs slides beneath the sink in the Mohs processing laboratory. 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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