Ut Endocrinology/Lipoprotein Laboratory

CLIA Laboratory Citation Details

3
Total Citations
5
Total Deficiencyies
3
Unique D-Tags
CMS Certification Number 44D0314742
Address 956 Court Ave, Rm A223 & A229, Memphis, TN, 38103
City Memphis
State TN
Zip Code38103
Phone(901) 763-3636

Citation History (3 surveys)

Survey - March 18, 2024

Survey Type: Standard

Survey Event ID: OG2J11

Deficiency Tags: D5439

Summary:

Summary Statement of Deficiencies 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 observation of the laboratory, review of manufacturer's instructions for use and calibration records, lack of documentation, review of patient test results, review of the Centers for Medicare and Medicaid Services Clinical Laboratory Improvement Amendments (CLIA) Application for Certification (Form CMS 116), and staff interview, the laboratory failed to perform calibration verification for the chemistry and endocrinology tests performed on the Siemens Immulite 1000 instrument in 2022, 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 -- 2023, and 2024 with approximately 600 patient tests performed during the period when calibration verification was not performed. The findings include: 1. Observation of the laboratory on 03/18/24 at 8:45 am revealed the Siemens Immulite 1000 instrument (serial number 5511) used for performing patient testing for chemistry and endocrinology on clinical research patients. The laboratory director stated during observation that the test results are released to the research team and used in the treatment decisions for patients. 2. A review of the manufacturer's package inserts and calibration records revealed the following methods were calibrated using two levels of calibrators: Cortisol, C-Peptide, Insulin, Free Thyroxine (FT4), Free Triiodothyronine (FT3), and Thyroid Stimulating Hormone (TSH). 3. No calibration verification records were available on the date of the survey for 2022, 2023, or 2024. 4. A review of patient reports revealed Insulin levels reported on two patients on 09/26/22; Cortisol, TSH, FT4, and FT3 reported on three patients on 08/07/23, Cortisol, TSH, and FT4 reported on 11/28/23 on two patients. 5. A review of Form CMS 116 revealed the laboratory performs approximately 300 tests per year for the six analytes performed on the Siemens Immulite 1000. 6. The laboratory director confirmed during an interview on 03/18/24 at 12:05 pm that the laboratory failed to verify the calibration of the six analytes performed on the Siemens Immulite 1000 chemistry instrument in 2022, 2023 and 2024. -- 2 of 2 --

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Survey - August 7, 2019

Survey Type: Special

Survey Event ID: SWZK11

Deficiency Tags: D2096 D2016

Summary:

Summary Statement of Deficiencies D2016 SUCCESSFUL PARTICIPATION CFR(s): 493.803(a)(b)(c) (a) Each laboratory performing nonwaived testing must successfully participate in a proficiency testing program approved by CMS, if applicable, as described in subpart I of this part for each specialty, subspecialty, and analyte or test in which the laboratory is certified under CLIA. (b) Except as specified in paragraph (c) of this section, if a laboratory fails to participate successfully in proficiency testing for a given specialty, subspecialty, analyte or test, as defined in this section, or fails to take remedial action when an individual fails gynecologic cytology, CMS imposes sanctions, as specified in subpart R of this part. (c) If a laboratory fails to perform successfully in a CMS- approved proficiency testing program, for the initial unsuccessful performance, CMS may direct the laboratory to undertake training of its personnel or to obtain technical assistance, or both, rather than imposing alternative or principle sanctions except when one or more of the following conditions exists: (1) There is immediate jeopardy to patient health and safety. (2) The laboratory fails to provide CMS or a CMS agent with satisfactory evidence that it has taken steps to correct the problem identified by the unsuccessful proficiency testing performance. (3) The laboratory has a poor compliance history. This CONDITION is not met as evidenced by: The laboratory failed to maintain satisfactory performance for the calcium analyte for two consecutive events, resulting in the first unsuccessful proficiency testing (PT) occurrence. (Refer to D2096) D2096 ROUTINE CHEMISTRY CFR(s): 493.841(f) Failure to achieve satisfactory performance for the same analyte or test in two consecutive testing events or two out of three consecutive testing events is 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 -- unsuccessful performance. This STANDARD is not met as evidenced by: Based on a desk review of the Centers for Medicare and Medicaid Services Casper Report 155 (CMS 155) and the laboratory's 2019 proficiency testing (PT) records, the laboratory failed to maintain satisfactory performance for two consecutive events for the calcium analyte, resulting in the first unsuccessful occurrence. The finding include: 1) Review of the CMS 155 report revealed the following unsatisfactory scores for the calcium analyte: 2019 event one = 40%, 2019 event two = 40%. 2) Review of the laboratory's 2019 event one Chemistry PT performance evaluation report revealed the following for the calcium analyte: Sample numbers CHM-01, CHM-02 and CHM-04 scored as unacceptable, resulting in a score of 40%. 3) Review of the laboratory's 2019 event two Chemistry PT performance evaluation report revealed the following for the calcium analyte: Sample numbers CHM-06, CHM-07 and CHM-09 scored as unacceptable, resulting in a score of 40%, and the first unsuccessful PT occurrence for the calcium analyte. -- 2 of 2 --

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Survey - May 10, 2019

Survey Type: Special

Survey Event ID: NEBP11

Deficiency Tags: D2096 D2016

Summary:

Summary Statement of Deficiencies D2016 SUCCESSFUL PARTICIPATION CFR(s): 493.803(a)(b)(c) (a) Each laboratory performing nonwaived testing must successfully participate in a proficiency testing program approved by CMS, if applicable, as described in subpart I of this part for each specialty, subspecialty, and analyte or test in which the laboratory is certified under CLIA. (b) Except as specified in paragraph (c) of this section, if a laboratory fails to participate successfully in proficiency testing for a given specialty, subspecialty, analyte or test, as defined in this section, or fails to take remedial action when an individual fails gynecologic cytology, CMS imposes sanctions, as specified in subpart R of this part. (c) If a laboratory fails to perform successfully in a CMS- approved proficiency testing program, for the initial unsuccessful performance, CMS may direct the laboratory to undertake training of its personnel or to obtain technical assistance, or both, rather than imposing alternative or principle sanctions except when one or more of the following conditions exists: (1) There is immediate jeopardy to patient health and safety. (2) The laboratory fails to provide CMS or a CMS agent with satisfactory evidence that it has taken steps to correct the problem identified by the unsuccessful proficiency testing performance. (3) The laboratory has a poor compliance history. This CONDITION is not met as evidenced by: The laboratory failed to maintain satisfactory performance for the glucose analyte for two consecutive proficiency testing (PT) events resulting in the first unsuccessful PT occurrence for the glucose analyte. (Refer to D2096) D2096 ROUTINE CHEMISTRY CFR(s): 493.841(f) Failure to achieve satisfactory performance for the same analyte or test in two consecutive testing events or two out of three consecutive testing events is 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 -- unsuccessful performance. This STANDARD is not met as evidenced by: Based on a desk review of the Centers for Medicare and Medicaid Casper Report 155 (CMS 155) and the laboratory's 2018 and 2019 proficiency testing (PT) records, the laboratory failed to maintain satisfactory performance for the glucose analyte, resulting in the first unsuccessful occurrence. The findings include: 1) Review of the CMS 155 revealed the following unsatisfactory scores for the glucose analyte: 2018 event 3 = 40%; 2019 event one = 40%. 2) Review of the laboratory's 2018 event 3 PT performance evaluation report revealed the following for the glucose analyte: Sample numbers CHM-11, CHM-13, and CHM-15 scored as unacceptable, resulting in a score of 40%. 3) Review of the laboratory's 2019 event 1 PT performance evaluation report revealed the following for the glucose analyte: Sample numbers CHM-03, CHM-04, and CHM-05 scored as unacceptable, resulting in a score of 40%, and the first unsuccessful PT occurrence. -- 2 of 2 --

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