Description of Event or Problem · 1
ASSAYS APPROVED BY THE CENTER FOR BIOLOGICS AND RESEARCH (CBER) FOR USE IN BLOOD DONOR SCREENING MUST INDICATE THE SPECIFICITY OF THE PRODUCT IN THE PACKAGE INSERT. THE PACKAGE INSERT FOR THE VIRONOSTIKA HTLV I/II ASSAY (MFG BY BIOMERIEUX, INC., HAZELWOOD, MO AND DISTRIBUTED BY ORTHO CLINICAL DIAGNOSTIC) STATES THAT THE ASSAY HAS A CALCULATED SPECIFICITY OF 99.95%. FACILITY HAS USED THE ABOVE ASSAY SINCE MID-1997. THIS COMPLAINT FOCUSES ON THE DONOR SCREENING EXPERIENCE FROM 1/01 THROUGH 12/01. DURING THIS PERIOD, BOTH THE INITIAL AND REPEAT REACTIVE RATES HAVE CONSISTENTLY EXCEEDED THE ESTIMATED SPCIFICITY BASED ON CLINICAL DATA PUBLISHED IN THE PACKAGE INSERT. THIS LACK OF SPECIFICITY HAS RESULTED IN THE LOSS OF THOUSANDS OF DONORS FROM THE VOLUNTEER BLOOD DONOR POOL. FACILITY IN EXCESS OF 7 MILLION DONOR SCREENING PROFILES ANNUALLY AND ARE GEOGRAPHICALLY LOCATED THROUGHOUT THE COUNTRY. THE SPECIFICITY OF THIS ASSAY EXPERIENCED ACROSS THE FACILITY'S SYSTEM IN 2001 WAS 99.92% WITH A 95% CI OF 99.91-99.92% BASED ON 7.338 MILLION TESTS ON DONOR SAMPLES. THE SPECIFICITY STATED IN THE PACKAGE INSERT IS 99.95% WITH A 95% CI OF 99.89-99.98% BASED ON 11,415 TESTS ON DONOR SAMPLES. MULITPLE COMPLAINTS HAVE BEEN FILED WITH THE DISTRIBUTOR (ORTHO CLINICAL DIAGNOSTICS) REGARDING THE POOR PERFORMANCE CHARACTERISTICS OF THIS ASSAY. SEVERAL MONTHS FOLLOWING THE INITIAL COMPLAINTS THE FACILITY WAS NOTIFIED THAT THE VENDOR (BIOMERIEUX, INC) COULD NOT DUPLICATE THE RESULTS THEY EXPERIENCED. THE VENDOR HAS STATED THAT THEY HAVE NOT OBSERVED A TREND OR DRIFT OF SPECIFICITY WHEN THE ASSAY IS TESTED WITH IN-HOUSE PANELS AND ARE UNABLE TO DEMONSTRATE ANY DEVIATION IN PRODUCT PERFORMANCE THAT CORRESPONDS TO THE FIELD REACTIVE RATE EXPERIENCE. THE DATA FROM THE FACILITY'S EXPERIENCE WITH THE VIRONOSTIKA HTLV I/II ASSAY INDICATE THAT THE CLINICAL DATA REPRESENTED IN THE PACKAGE INSERT REPRESENT AN INADEQUATE SAMPLE SIZE TO DETERMINE TRUE ASSAY SPECIFICITY. FACILITY WOULD RECOMMEND THAT THE PACKAGE INSERT BE MODIFIED TO REFLECT THE TRUE PERFORMANCE OF THE ASSAY.