CBER Whole Blood and Blood Component Labeling Jennifer Jones Consumer Safety Officer CBER, OBRR, DBA...

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C C B B E R Whole Blood and Blood Component Labeling Jennifer Jones Consumer Safety Officer CBER, OBRR, DBA September 16, 2009

Transcript of CBER Whole Blood and Blood Component Labeling Jennifer Jones Consumer Safety Officer CBER, OBRR, DBA...

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Whole Blood and Blood Component Labeling

Jennifer Jones Consumer Safety Officer

CBER, OBRR, DBA

September 16, 2009

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Outline

• Labeling regulations• ISBT 128 • Request for an alternative procedure• Suggestions to facilitate review• Common pitfalls with ISBT 128 submissions• Circular of Information (COI)

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Labeling Regulations

• Labeling, general requirements (606.120)• Certain information must be machine readable

(606.121(c)(13))– Unique facility identifier– Unit number relating to donor– Product code– Donor group and type

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Labeling Regulations (cont.)

• Container labels (606.121)– Container label must include proper name of the product

and modifier, if applicable (e.g. Irradiated, Leukocytes Reduced)

– Tie tags are allowed for positive antibody screens, emergency use & additional information regarding autologous use – 606.121(j)

• Circular of Information (606.122)– For transfusible components only– Guidance for Industry: An Acceptable Circular of

Information for the Use of Human Blood and Blood Components (12/03)

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Labeling Guidance

• Guideline for the Uniform Labeling of Blood and Blood Components (Codabar) (8/85)

• Guidance for Industry: Recognition and Use of a Standard for Uniform Blood and Blood Component Container Labels (ISBT) (09/06)– United States Industry Consensus Standard for the Uniform

Labeling of Blood and Blood Components Using ISBT 128 v.2.0.0, 11/05

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ISBT 128 Background• AABB requirement • Use of ISBT 128 is governed and administered

by International Council for Commonality in Blood Banking Automation, Inc. (ICCBBA)

• FDA recognizes as acceptable the standard for blood component and blood component container labels the ICCBBA “United States Industry Consensus Standard for the Uniform Labeling of Blood and Blood Components Using ISBT 128 v.2.0.0 dated November 2005

• FDA recognizes as acceptable ISBT 128 as a labeling standard in addition to Codabar

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ISBT 128 Label Submission – Firms Not Licensed

• Firm must request for an alternative procedure for Whole Blood and Red Blood Cells

• No labels should be submitted• Labels for unlicensed products are not

reviewed by CBER• An approval letter is mailed to the firm

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ISBT 128 Label Submission – Licensed Firms

• Prior Approval Supplement (PAS) labeling supplement

• Submission should include:– Labels

• Include at least one full-face label, the rest may be product overlay labels

– Form FDA 356h– Form FDA 2567– Request for an alternative procedure for Whole Blood and

Red Blood Cells

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Request for an Alternative Procedure

• Request an alternative procedure from 21 CFR 606.121(e)(1)(ii) under the provisions of 21 CFR 640.120 to delete the name of the applicable anticoagulant immediately preceding and of no less prominence than the proper name of the blood product

• Firms not licensed must request an alternative procedure

• Licensed firms must request an alternative procedure and submit labels for approval

• On the label review checklists, “Approved as a variance to 21 CFR 606.121 under 21 CFR 640.120” will be checked to indicate approval for the alternative procedure

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ISBT 128 Labels Reviewed by CBER

• Labels submitted by licensed manufacturers• Licensed products • Labels that have not been previously approved• Both product labels and certain other labels• List of labels to submit for review on slides 12-

15 is for those facilities that have had their Codabar product labels previously approved under their U.S. License Number

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ISBT 128 Labels Not Reviewed by CBER

• Unlicensed products• Products for which the manufacturer does not

hold a license• New licensed products

– These labels should be submitted at the time of application for that product, not with the ISBT label submission

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Product Labels Reviewed by CBER• WHOLE BLOOD label (for each approved anticoagulant

currently in use)• RED BLOOD CELLS label (for each approved anticoagulant

currently in use)• RED BLOOD CELLS label (for one approved additive

currently in use)• RED BLOOD CELLS FROZEN label • RED BLOOD CELLS DEGLYCEROLIZED label • RED BLOOD CELLS LEUKOCYTES REDUCED label (for one

approved anticoagulant currently in use)• RED BLOOD CELLS IRRADIATED label (for one approved

anticoagulant currently in use)• RED BLOOD CELLS LEUKOCYTES REDUCED

IRRADIATED label (for one approved anticoagulant currently in use)

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Product Labels Reviewed by CBER (cont.)

• RED BLOOD CELLS BY PHERESIS label (for one approved anticoagulant currently in use)

• RED BLOOD CELLS LEUKOCYTES REDUCED BY PHERESIS label (for one approved anticoagulant currently in use)

• FRESH FROZEN PLASMA label (for one approved anticoagulant currently in use)

• FRESH FROZEN PLASMA (BY APHERESIS) label (for one approved anticoagulant currently in use)

• CRYOPRECIPITATED AHF label• SOURCE LEUKOCYTES label (for one approved

anticoagulant currently in use)

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Product Labels Reviewed by CBER (cont.)

• PLATELETS label (for one approved anticoagulant currently in use)

• PLATELETS LEUKOCYTES REDUCED label (for one approved anticoagulant currently in use)

• PLATELETS IRRADIATED label (for one approved anticoagulant currently in use)

• PLATELETS PHERESIS label (for one approved anticoagulant currently in use)

• PLATELETS PHERESIS IRRADIATED label (for one approved anticoagulant currently in use)

• PLATELETS PHERESIS LEUKOCYTES REDUCED label (for one approved anticoagulant currently in use)

• PLATELETS PHERESIS LEUKOCYTES REDUCED IRRADIATED label (for one approved anticoagulant currently in use)

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Other Labels Reviewed by CBER

• ABO/Rh label (one of each blood type)• Donation Identification Number • For Autologous Use Only label with the

Intended Recipient Information label• Either one full face label (4 X 4) or one label

of each of the 4 quadrants

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Full Face Label Example

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Product Overlay Label Examples

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Labels Approved with Comments

• Labels are approved but the firm is advised to make the changes indicated on the review checklist with the next software change or revision

• It is not necessary to resubmit the changes to FDA for approval

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Approved with Comment ExamplesItem Incorrect Correct U.S. Industry

Consenus Std (v2.0.0)

Rx Only Rx Only. or Rx ONLY.

Rx Only Pg. 27

Rx ONLY or Rx only

Rx Only Pg. 27

RX ONLY Rx Only Pg. 27

Degree symbolin thetemperature

1 – 6◦C 1 – 6 C Pg. 29

Periods afterabbreviations

Approx. or mL. Approx or mL Pg. 51-53

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Labels Not Approved

• Review checklist will list the necessary changes to be made

• For approval of these labels, the firm must make the corrections and resubmit labels to FDA

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Not Approved ExamplesItem Incorrect Correct U.S. Industry

Consenus Std (v2.0.0)

Abbreviated legal name

Community Blood Bnk of E. Anytown, Inc.

Community Blood Bank of East Anytown, Inc.

Full legal name is not present on label

Blood Bank Blood Bank, Inc. Pg. 27

License number None U.S. License Number 9999

Pg. 27

Divided Units Nothing present in code. For example: E4520V00

On divided units the code should have an A, B, or C indicating divided (E4520VA0) and the term Divided should be on the label in the attribute line.

Pg. 18 - 19

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Suggestions To Facilitate Review

• Review the website link provided for the guidelines and the chart of common errors found–Make any corrections necessary before

sending in submission to the FDA• If corrections are necessary during the review

process, make them as quickly as possible and return to FDA with a completed Form FDA 2567

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Suggestions To Facilitate Review (cont.)

• Send in a complete submission with appropriate forms and request for the alternative procedure

• Only send in labels for licensed products• If submitting product overlay labels, send in at

least one full-face label containing the facility information and caution statements in the upper-left quadrant of the label

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Common Pitfalls• Form FDA 2567 is not signed • Cover letter does not request the alternative

procedure• Only product overlay labels are submitted• Sending in labels for products not licensed at

your firm• Not sending in the intended recipient

information label with autologous labels

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Common Pitfalls (cont.)

• Not using the firm’s full legal name on the labels

• Printing the expiration time on all products – Only necessary if the expiration time is 72 hours or less

(606.121(c)(4))

• Omitting the license number on licensed products (606.121(c)(2))

• Submitting the Donation Identification Number without the proper facility code

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Circular of Information (COI)

• Part of product labeling• CFR requires that it be available to medical

personnel involved in transfusion processes• Firms may implement the FDA accepted AABB

COI (July 2002) or may create their own circular

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COI Submissions• COI is considered labeling• When adding revisions to the current AABB

COI, or when implementing future versions of AABB COI, contact your CSO to discuss the proper reporting category

• If preparing your own COI, submit as a PAS labeling supplement with the following items:– Copy of Circular of Information– Form FDA 356h– Form FDA 2567

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When to submit your COI

• Each firm must submit a circular (either AABB FDA accepted version or the firm’s own version) to the FDA for approval before use is implemented

• Once the firm has received FDA approval, it is only necessary to submit the COI when there are revisions made to it

• A COI does not need to be submitted with every type of submission

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Where to obtain information:Labeling

• Guideline for the Uniform Labeling of Blood and Blood Components (Codabar) (8/85)

• Guidance for Industry: Recognition and Use of a Standard for Uniform Blood and Blood Component Container Labels (9/06)

• United States Industry Consensus Standard for the Uniform Labeling of Blood and Blood Components Using ISBT 128 (11/05)

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Where to obtain information:Labeling (cont.)

• Guidance for Industry: Bar Code Label Requirements Questions and Answers (10/06)

• http://www.iccbba.org

• http://www.fda.gov/BiologicsBloodVaccines/DevelopmentApprovalProcess/AdvertisingLabelingPromotionalMaterials/InternationalSocietyofBloodTransfusionISBT/default.htm

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Where to obtain information: COI

• Guidance for Industry: An Acceptable Circular of Information for the Use of Human Blood and Blood Components (12/03)

• http://www.aabb.org