When
you peel back the layers of causes leading to serious FDA enforcement action,
it comes down to a handful of fundamental reasons.
1. Management does not
know what is required.
Executive
and senior management may not have regulatory experience. MBA programs may
offer courses on Quality, but it is more about the popular concepts of Lean
Manufacturing, not the Food and Drug Cosmetic Act or the Code of Federal
Regulations and CGMPs. Some may go as far as to think that if you are doing Six
Sigma, you have a quality program. If you have a quality program, you have the
FDA base covered. There is a mental disconnect with CGMPs as legal requirements. It just so happens that CGMPs are also a business enabler that
drives reliable processes, product quality, and uninterrupted patient supply. And
management must acknowledge and embrace these legal requirements just as much
as it does SEC, EPA, EEOC, and other business laws.
2. The Quality Unit lacks
the capability to detect problems and report to management.
Management
may have regular status updates on how well the market is responding in Europe
to a new product launch, or how the new ad campaign is affecting the
Southeast Sales Region. But management often flies blind when it comes to
knowing at any moment whether the operation is in a state-of-control. That
knowledge is thought to come with regulatory inspections. You deal with the
FDA483 when it comes, and that buys you time until the next inspection. The
Quality unit often buys-in to this reactive mode of problem detection since this
is when resources are most likely to be justified. The Quality Unit must
develop the systems and the capability to detect unacceptable trends and be
empowered to report problems directly to management. Such a mindset is
essential to move from a reactive to an anticipating organizational culture.
3. The organization cannot
plan and execute permanent solutions.
It’s
one thing to know about a problem and something entirely different to do
something about it. The best position to be in prior to a regulatory inspection
is to be able to say, “There’s nothing you will find that we don’t already know about. Not only do we have a plan to address these problem, but also our plan
is on schedule.” But all too often projects to prevent failure move to
the bottom of the priority list for resources. If they do get funded, the
projects are not directed toward a permanent solution, or managed to a verifiable
conclusion. Not only
must compliance projects must be resourced and managed, they also require
oversight and governance to ensure that the projects are supported and completed on time.
4. Lack of integrity.
Then
we have the phenomenon of doing whatever it takes for self-preservation over
the health and welfare of the patients we serve. No degree of knowledge of the
requirements or the presence of highly effective detection and escalation
systems can prevent dishonest individuals from violating public trust. What we
can do is have a zero-tolerance Integrity Policy that is part of every employee’s training
curriculum, and to make it safe for someone to voice his or her concern should
they witness a violation. In addition, training on Good Documentation practices
will help to standardize record entries and how to document correction of
errors. This will counter the perception of fraud for honest mistakes. The
dishonest ones—well, that’s another matter.
Opinion
Survey: Reasons Companies Come Under
Consent Decrees
When
the FDA starts moving against your company is not the time for introspection. Take this quick survey and use the results in an internally facilitated discussion. Now is the best time.
How would you rate your company? What are the
implications for your collective results? Most
of all—take action.
5
= Strongly Agree
4
= Agree
3
= Not sure
2
= Disagree
1
= Strongly Disagree
_____ a. Our management demonstrates visible support
for CGMP projects to ensure our compliance position is strong.
_____ b. Our Quality Unit has robust
processes that provide management the means to know the state-of-control and to take decisive action.
_____ c. We have a good history of directing
teams toward potential compliance problems and finishing on time.
_____ d. We have an Integrity Policy and
everyone knows how to confidentially report a potential violation.
The
QA Pharm
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