May 17, 2012

The Top 10 FERC Enforceable Standards in 2009

We knew it was coming. FERC enforcement actions picked up significantly in 2009. But what surprised us most was the eye-popping 214 violations for PRC-005-1.

Top 10 FERC Enforceable Standards of 2009

So, what exactly is PRC-005-1?

Simply put, the NERC PRC-005-1 standard says (but is not limited to the following – see below for link/download of standard):

  • Owners of generation Protection Systems shall have a maintenance and testing program for all protection devices that affect the reliability of the Bulk Electric System (BES).
  • The program must include a maintenance and testing interval for each type of device and the basis used for determining that interval.
  • The owner must provide documentation of its system maintenance and testing program and the implementation of that program to its Regional Reliability Organization on request within 30 calendar days.
  • The program must provide the evidence that each Protection System device was maintained and tested within the defined intervals including the last tested/maintained date.

You can download the NERC PRC-005-1 Standard here.

Why has complying with PRC-005-1 been such a challenge to utilities?

The legacy of the unregulated past of both small and large utilities has left them with islands of disconnected data related to physical devices and assets that have an affect on the BES. This data consists primarily of work orders, maintenance activities, test results and supporting evidentiary documentation. Unfortunately, all of this data tends to reside in disparate systems such as ERP, spreadsheets, hard copies, custom databases, test systems, etc., and are typically spread across various departments and facilities in the enterprise. If a utility is found in non-compliance with the NERC Standard during an audit, it can result in fines from the tens to hundreds of thousands of dollars.

Achieving compliance with PRC-005-1

As daunting a challenge this might sound, there is a cost effective and simple solution that provides a central hub for real-time visual compliance to NERC PRC Standards. CATSWeb ER seamlessly integrates data from dozens of differing sources into a single repository and creates logical relationships amongst this data to perform measurements and analytics in real-time dashboards. This provides a visual status of PRC compliance of all devices and assets across the enterprise. Users also get real-time alerts and notifications as trends towards non-compliance occur, well before a state of non-compliance happens. The system also maintains a complete auditable history that’s ready for an audit of all devices, issues and actions in maintaining control and compliance.

Visit the NERC website to view enforcement actions, settlements and penalties.

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Part II: Former FDA Inspector Miles | Key to Avoiding More Trouble with the FDA is Identifying Root Cause

Ken Miles, Former FDA Inspector

Ken Miles, Former FDA Inspector

Ken Miles, a 28 year veteran of the FDA, is today a widely-respected industry consultant to the medical device industry. He draws on his extensive experience to help firms effectively and efficiently comply with FDA requirements. Ken’s expertise includes evaluating Good Manufacture Practice (GMP) and Good Laboratory Practice (GLP) compliance, Quality System Regulations, and QSIT certification inspections (Management, Design, Process Controls, and CAPA).

In this multi-part series, we talked with Ken about FDA medical device inspections, CAPA, quality systems, audits, training and more.

Q: Where do you think companies fall short when it comes to implementing CAPA systems?

A: Some companies have a great CAPA program that is tied in with metrics, management reviews, etc., but ultimately may be only looking at trend analysis studies of post-production products. Unfortunately, they neglect trends with suppliers and internal production operations, or visa versa.  Valuable data can be obtained for correcting problems in their factory by looking at all trends: suppliers’ and in-house non-conforming materials and components, scrap rates, training issues, complaints, competitors’ non conformances (ie Warning Letter), etc.  Sometimes they’ll discover ”a peak in noncomformance with a certain product line”, but they fail to break it down to reveal that the nonconformance(s) only involve one or two models within the product line which is often the real culprit.

Company managers need to ask themselves, is it one model or all models? A certain shift? A certain part of the plant? Finding the root cause is very important in order to effectively resolve the problem(s). Companies need to isolate the problem and find out if it’s widespread, model specific, or a component. The big picture of using metrics is great, however, if you can’t drill down to the specific problem and root cause, then it’s really not solving the problem.

Q: Can you give us some examples of what you saw as an FDA inspector?

A: One time I was at a large global manufacturer and they had a lot of returned motherboards for ultrasound systems (hundreds of boards returned per month.) Instead of analyzing and finding the root cause of the problem of all these returned boards, they would simply rework and repair them – over and over again. These boards had a very high rate of return, but they would all just go into a big hopper for rework. They should’ve taken the time to do a root cause analysis, but they didn’t, preferring to continue to fix them. None of this was logged into a system, and no failure investigations were ever conducted.  Think of the risk to consumers and to the companies’ reputation and earnings! Think of the enormous waste in time and funds and other resources used for fixing the same problems over and over again.

This firm ended up having a major investigation by the FDA with recalls and monetary fines in the millions of dollars. If they had an effective CAPA system in place with root cause and failure investigations, they could’ve fixed the problem once and for all instead of reworking hundreds of motherboards per month.

Q: Why do you think medical device companies have such a problem with CAPA?

A: The biggest problem I see has to do with a lack of human resources. Typically a person in charge of CAPA has too many tasks and things tend to fall through the cracks. This generally happens to smaller companies with growing pains. That said, it also happens with the biggest ones, too. Bottom-line: the failure is about not devoting enough resources to CAPA, and letting other issues distract them because they are overworked.

Click here to learn more about CAPA Systems.

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UPDATE: FDA Signals Renewed Commitment to Risk Management

fda-logoIn Washington, D.C., experts tracking the political shifting sands often advise you to watch what someone does, not what they say. Applying that to the FDA suggests the agency is starting to take risk management enforcement a bit more seriously.

Here’s a good example. Earlier this week (Feb. 16) the agency approved a risk management program to inform healthcare providers and their patients about the risks of a class of drugs called Erythropoiesis-Stimulating Agents (ESAs) manufactured by Amgen Inc. The company’s risk management program or Risk Evaluation and Mitigation Strategy (REMS), requires health care professionals to provide their patients receiving an ESA with a Medication Guide that contains information for patients on how to safely use a drug.

And earlier this month, the agency requested a 23% hike in its budget to help it more aggressively pursue food, drug and device safety (plus its new tobacco initiative).

More action and more dollars could add up to a more active FDA in 2010.

Make sure to read our previous post: Risk Management Matures Beyond the Spreadsheet

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FDA CDRH Electronic Submissions Up Significantly in 2009

fda-logoNumbers don’t lie. Reviewing the year-end numbers for FDA’s CDRH electronic submissions (AS2 Electronic Submissions Gateway) provides some eye popping stats.  This is an early indicator that electronic medical device reporting submissions have significantly increased over 2008, and certainly suggests they’ll rise even faster this year after the final rule is published.

Comment period on the draft guidance ended November 2009. The final ruling is expected within weeks. According to some FDA insiders, many were relieved the agency wasn’t overwhelmed with comments (slightly over two dozen comments were filed), and the ones received were definitely “workable”.

So, what did 2009 numbers look like?

Source: FDA

Source: FDA

As the chart shows, early 2009 got off to a slow start, but picked up significantly in the fourth quarter of the year.

CDRH Year over Year Submissions Stats

Source: FDA

But when comparing 2008 vs. 2009, total submission numbers jumped from 4,619 to 21,296. It’s apparent that the device industry has picked up the pace when it comes to electronic submissions to FDA. And if this isn’t a wake up call for device companies to move away from paper 3500A submissions to eMDR, we don’t know what is.

We’ll be keeping a close eye on this through 2010.

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Registration Now Open for AssurX's Electric Reliability Virtual Summit

WHEN: Thursday, January 28, 2010 – 10 am – 2pm (Pacific)

REGISTER: https://www2.gotomeeting.com/register/554360930

WHO SHOULD ATTEND: All AssurX Energy/Utility Customers

AGENDA:

How to Manage NERC CIP Workflows & Documentation
NERC CIP Compliance Management – CIP-002 thru CIP-009 reached the Auditably Compliant stage July 1st, 2009. In this talk we will take a look at best practices for managing CIP workflows including configuration change management and process/plan review workflows.

How to Manage a NERC Compliance Framework
Part of a NERC audit includes submitting information about how your internal documentation (i.e. procedures, policies, etc.) relates to each applicable requirement. This presentation will demonstrate how CATSWeb ER can be used to establish this compliance framework.

NERC Standard Update Service
View how the NERC Standard Update Service is used to import new NERC standards and file attachments into your CATSWeb ER system.

Self Certification
Using the new CATSWeb 16Q Service Pack rules engine, view how your self-certification preparation process can be automated to create and assign all Gap Analysis records and monitor when all Gaps have been completed.

Using CATSWeb for PRC-005-1 Compliance

Demonstration of CATSWeb configured as a standalone system as well as an integration hub with various Work Order Management, ERP and Test Systems assuring that assets which effect the BES are in PRC-005-1 compliance.

Taking your CATSWeb ER system beyond your expectations
An opportunity to learn how companies use CATSWeb ER to steamline the management of documents, assets, approvals, certifications, testing, exceptions, etc.

Sessions will last anywhere from 20 – 45 minutes each and will be followed by a 5 – 10 minute Q&A, as well as a midway break. This four hour event will be recorded and available for replay shortly afterwards. Presentations will be available for download immediately following the event.

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Tobacco, Food, eMDR, Transparency, More Staff Add Up to a Big 2009 for FDA – and 2010 Looks Even Bigger

fda-logoThe early part of the 21st century was a tough time for the FDA. Its budget was curtailed, it lost some important personnel, and the word “acting” kept appearing on people’s business cards.

But 2009 just might be going down in history as the Year of the FDA Turnaround.

In October, the agency announced a long-overdue hiring binge that signals an even stronger FDA is on tap for 2010.

Watch for the agency to get a bigger budget in the coming years – though much of that emphasis will be on the food side and perhaps less on the drug and device side. For FY 2010, the FDA requested a total budget of $3.2 billion. This amount is $511 million more than FY 2009 and represents a 19 percent increase — the largest ever in FDA history. They won’t get it all, but they’ll probably come close.

Here are some other FDA highlights in a big year:

FDA Finally Gets Tobacco

It took years of lobbying and a new President, but in June 2009 the FDA was given the power to regulate tobacco products. This is a huge victory for the agency. It remains to be seen how the FDA will use this new power, but its surge of activity in the second half of 2009 suggests they want to seize the initiative.

Lawrence Deyton, M.S.P.H., M.D., joined the U.S. Food and Drug Administration (FDA) on Sept. 14, 2009, as director of the agency’s new Center for Tobacco Products. He hit the ground running.

“Our objective is to use the best available science to develop and put into action effective public health strategies to reduce the enormous toll of illness and death caused by tobacco products,” Deyton said .

Deyton was also asked how the tobacco regulation differs from FDA’s regulation of drugs or medical devices?

“FDA’s regulatory role for drugs and medical devices is usually based on a safety and effectiveness standard. The tobacco act establishes a new standard: to regulate tobacco products based on a public health and population health standard.

Deyton noted that when FDA gets an application for a new drug to treat a disease, the agency normally considers studies of patients who have the disease. ”But when we get an application for a new tobacco product, the law tells us we have to consider whether permitting the product’s marketing protects the public health and we have to evaluate the effects of the product on the population as a whole. We’re directed to consider both users and nonusers, and whether our action might encourage people who don’t use tobacco products to begin using them, or encourage people who might otherwise quit to continue using them.”

Bottom-line: It was a huge turf battle victory for the FDA and increases the agency’s overall regulatory clout.

Risk Communications

The agency also took big strides forward in how it gets the word out to industry and the public regarding risk. In its Strategic Plan the agency spelled out its perceived role in communicating the risks of regulated product use, defining risk communication anew for a 21st century in which evolving technologies have enabled increased patient and consumer involvement in managing their health and well-being. The document defines the three key areas (science, capacity, and policy) in which strategic actions, in collaboration with relevant domestic and international stakeholders, can improve the generation, dissemination, and regulation of risk communication about regulated products. It also identifies and details 14 specific strategies.

“FDA is showing its commitment to the goals of the plan not just by identifying the strategies it will implement, but also by identifying over 70 actions the agency plans to take within the next few years to improve risk communication,” it says in the Strategic Plan. The document also identifies 14 of those actions that FDA plans to accomplish within the next 12 months.

Clearing Up Transparency

Echoing an Obama campaign promise to make government more open and accountable to taxpayers, the FDA also walked the walked and talked the talk with its new “transparency”  initiative with public meetings in June and November. The agency also opened a blog that, so far, has had a fair amount of uncensored comment both pro and con about agency performance.

Here (Finally) Comes the eMDR Guidance

In August, the FDA unveiled their proposed guidance for ultimately mandating electronic submission of mandatory adverse event reports. It took a long time to come to fruition, and some are lobbying the agency to push it back another year or two, but the simple fact that it was released was a big deal in 2009.

Guidance on Presenting Risk Info

Before unveiling the eMDR rule, the agency also issued  in May the important draft Guidance for Industry: Presenting Risk Information in Prescription Drug and Medical Device Promotion. The guidance is important on several levels, but perhaps the most important is that it addresses factors the FDA considers when evaluating ads and promotional labeling for prescription drugs, ads for restricted medical devices, and promotional labeling for all medical devices for their compliance with the Federal Food, Drug, and Cosmetic Act and relevant regulations.

In doing so, it cleared up a lot of confusion in the industry and signaled a revitalized FDA that was on the way back.

Putting The ‘Food’ Back In Food & Drug Administration

Responding in part to pressure from Congress and consumer groups over beef and other food contamination recalls, the FDA also revitalized its food enforcement in 2009, and this is also an area where the smart money says they’ll be even more active in 2010. In September, the agency capped a number of new food initiatives by unveiling a new reporting system that gives the agency new enforcement teeth when it comes to the food chain.

Here’s a prediction: FDA historians of the future are probably going to see 2009 as the year the agency picked itself up off the ground and started to flex its regulatory muscle again.

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Former FDA inspector Miles on What FDA Looks for During Inspections & the Importance of Strong CAPA Systems

Ken Miles, Former FDA Inspector

Ken Miles, Former FDA Inspector

Ken Miles, a 28 year veteran of the FDA, is today a widely-respected industry consultant to the medical device industry. He draws on his extensive experience to help firms effectively and efficiently comply with FDA requirements. Ken’s expertise includes evaluating Good Manufacture Practice (GMP) and Good Laboratory Practice (GLP) compliance, Quality System Regulations, and QSIT certification inspections (Management, Design, Process Controls, and CAPA).

In this multi-part series, we talked with Ken about FDA inspections, CAPA, quality systems, audits, training and more.

Q: When you were with the FDA, what did you look for during onsite inspections at medical device facilities?

A: What I primarily looked for was a robust quality management system that covered all of the key areas: CAPA, internal quality audit findings, training, MDRs and complaints, supplier quality, etc.   Supplier audits are also very important, and they should always tie back into CAPA and management review findings.

Q: You mention training as part of the overall quality management system –  what kind of problems did you see in that area?

A: The most common problem with training is that programs are often inadequate. Oftentimes procedures are either nonexistent or very poorly written. You need to have stringent management commitment and oversight, while also removing irresponsible people who can seriously damage the business. Procedures, management review and training are the primary areas that should generally be addressed through a CAPA program to make it work.

Q: Digging deeper, what were the CAPA-related issues you saw most often during inspections?

A: The one thing I saw often was that companies did not prioritize their CAPA items. You need to prioritize them using a risk-based approach. The highest priority ones should be put at the top of the list. Sounds like an obvious thing, but a lot of companies just throw all CAPA related issues into one bucket with no priority or even closure dates. If you don’t have some sort of prioritization system, you might become weighed down with too many assignments with no end in sight. Prioritize by low, medium and high priority, as well as severity of consequences. That would also imply that you have a target date, or closure date once you implement that program. A lot of companies don’t do that.

Q: You stress the importance of prioritizing and setting due dates for CAPA. Can you give us some examples of what you looked for during your inspections?

A: Medium and serious CAPA issues should be closed out within 30 or 90 days at the most. I’ve seen situations where CAPAs are still hanging out there after two or three years! And I’ve even some that have never closed or resolved! In certain situations, I’ve also seen CAPAs that don’t even have a closure date. Unfortunately, that’s typical of spreadsheet based CAPA systems.

In the next part, we will delve deeper into actual situations, and discuss some of the more egregious things that Ken Miles experienced as an FDA inspector.

Click here for more detailed information about CAPA.

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The Most Common Drug and Device GMP 483 Items

fda-logoIn a recent FDA presentation Foster City, CA, Mark Roh, Regional Food and Drug Director outlined the most common cited 483 items for both pharma and med device companies:

The most common Drug GMP FDA-483 (observational) items:

  • Responsibilities and procedures of the Quality Control unit are not in writing
  • Written procedures are not followed
  • Control procedures not established
  • Inadequate specificatons
  • inadequate written procedures
  • Inadequate failure analysis

The most common Medical Device GMP FDA-483 (observational) items:

  • Deficiencies in complaint file system
  • Inadequate CAPA procedures
  • Lack of written MDR procedures
  • Corrective and preventive actions not documented
  • Inadequate process validation

This doesn’t mean you won’t be cited for anything not listed in the bullet items or nabbed for all of the above. These are the most common observations cited by FDA personnel during an inspection. So now you may want to go back and take a good hard look at your SOPs, quality management system, CAPA process, complaint handling/MDRs as well as your validation documentation. Obviously training your personnel in these procedures and processes is also key.

Of course, everyone’s goal is not to end up here…

Also, you may want to check out our previous blog entry “Don’t Ignore 483s…it’s in Your Best Interest to Respond in Writing

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Angiotech Leverages SaaS Model for Global Complaint Handling System to Standardize and Improve Efficiency

AngiotechThe concept of implementing SaaS is moving ahead quickly, especially in the medical device arena. Perhaps that shouldn’t be surprising; most industry experts say that device firms tend to be a bit more innovative when it comes to embracing new technologies.

That may be why Angiotech made the decision to go with AssurX’s OnDemand (SaaS) model as opposed to on-premise implementation for their global complaint handling system. Angiotech is a global specialty pharmaceutical and medical device company that discovers, develops, and markets innovative technologies and medical products primarily for local diseases or for complications associated with medical device implants, surgical interventions and acute injury.

AssurX’s CATSWeb system is already rolled out across four facilities – three in the US and one in Puerto Rico – with Europe expected by the end of 2009.

Larry Murphy, Senior Manager, Corporate Quality, was part of the team that made the decision to go with the SaaS model because they needed to get up and running quicker.

“We got the blessing of the IT group after they reviewed the AssurX system and were able to get answers quickly about the level of security and support,” Murphy said. “As far as the users are concerned, they really like having everything centralized, including the reporting capabilities. We have significantly improved our efficiency and productivity,” added Murphy.

Prior to implementing an automated complaint handling system, various divisions of Angiotech were using either paper-based systems or homegrown Access database applications. Now the company-wide system using CATSWeb allows them to process complaints in a more structured and standardized manner that provides a much higher level of quality of information as well as the ability to track progress using metrics and dashboards.

Future plans include expansion of the current process and perhaps implementing electronic medical device reporting (eMDR) somewhere down the line.

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Don't Ignore 483s…it's in Your Best Interest to Respond in Writing

fda-logoEven though there’s no regulatory requirement to respond to an FDA 483 inspectional observations report, it’s in your best interest to do so in writing, according to FDA sources. In a recent presentation by Anita Richardson, Associate Director for Policy Office of Compliance & Biologics Quality, she outlined four reasons for submitting a comprehensive 483 response, and eight suggestions for an effective response.

Four reasons for submitting a well-prepared and timely 483 response:

  1. Could possibly mitigate an FDA compliance decision for further action (warning letter, etc.) “As a general rule, a Warning Letter should not be issued if the agency concludes that a firm’s corrective actions are adequate and that the violations that would have supported the letter have been corrected.”
  2. Demonstrates to the FDA (and other stakeholders) an understanding and acknowledgement of the observations
  3. Demonstrates to the FDA (and other stakeholders) a commitment to correct, i.e. the intent to voluntarily comply
  4. Establishes credibility with FDA

Eight suggestions for an effective 483 response

  1. Include a commitment/statement from senior leadership
  2. Address each observation separately
  3. Note whether you agree or disagree with the observation
  4. Provide corrective action accomplished and/or planned; tell FDA the plan
    • Be specific (e.g. observation-by-observation)
    • Be complete
    • Be realistic
    • Be able to deliver what you promise
    • Address affected products
  5. Provide time frames for correction
  6. Provide method of verification and/or monitoring for corrections
  7. Consider submitting documentation of corrections where reasonable & feasible
  8. BE TIMELY

Good advice. And remember…

“A well-reasoned, complete, and timely 483 response is in your best interest.”

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