European Communities (Quality System for Blood Establishments) Regulations 2006

S.I. No. 552 of 2006 .

I, MARY HARNEY, Minister for Health and Children, in exercise of the powers conferred on me by section 3 of the European Communities Act 1972 (No.27 of 1972) and for the purpose of giving effect to Directive 2005/62/EC of the European Commission implementing Directive 2002/98/EC of the European Parliament and of the Council as regards Community standards and specifications relating to a quality system for blood establishments, hereby make the following Regulations:

1.        These Regulations may be cited as the European Communities (Quality System for Blood Establishments) Regulations 2006.

2.        These Regulations shall come into operation on 26 October, 2006.

Interpretation

3.        (1)  In these Regulations-

-�computerised system-� means a system including the input of data, electronic processing and the output of information to be used either for reporting, automatic control or documentation;

-�good practice-� means all elements in established practice that collectively will lead to final blood or blood components that consistently meet predefined specifications and compliance with defined regulations;

-�mobile site-� means a temporary or movable place used for the collection of blood and blood components which is in a location outside of but under the control of the blood establishment;

-�processing-� means any step in the preparation of a blood component that is carried out between the collection of blood and the issuing of a blood component;

-�qualification-�, as part of validation, means the action of verifying that any personnel, premises, equipment or material works correctly and delivers the expected results;

-�quality assurance-� means all the activities from blood collection to distribution made with the object of ensuring that blood and blood components are of the quality required for their intended use;

-�quality control-� means part of a quality system focused on fulfilling quality requirements;

-�quality management-� means the co-ordinated activities to direct and control an organisation with regard to quality at all levels within the blood establishment;

-�quality system-� means the organisational structure, responsibilities, procedures, processes, and resources for implementing quality management;

-�quarantine-� means the physical isolation of blood components or incoming materials/reagents over a variable period of time while awaiting acceptance, issuance or rejection of the blood components or incoming materials/reagents;

-�specification-� means a description of the criteria that must be fulfilled in order to achieve the required quality standard;

-�standard-� means the requirements that serve as the basis for comparison;

-�trace-back-� means the process of investigating a report of a suspected transfusion-associated adverse reaction in a recipient in order to identify a potentially implicated donor;

-�validation-� means the establishment of documented and objective evidence that the pre-defined requirements for a specific procedure or process can be consistently fulfilled;

-�written procedures-� means controlled documents that describe how specified operations are to be carried out.

(2)  A word or expression that is used in these Regulations and is also used in the Directive 2002/98/EC of the European Parliament and of the Council of 27 January 2003 has, unless the contrary intention appears, the same meaning in these Regulations as it has in Directive 2002/98/EC.

Quality system standards and specifications

4.   Each blood establishment shall have a quality system in place which complies with the Community standards and specifications set out in the Schedule to these Regulations.

5.   Each blood establishment shall ensure that for blood and blood components imported from outside the European Community and intended for use or distribution in the Community, there is a quality system for blood establishments in the stages preceding importation equivalent to the quality system provided for in Regulation 4 hereof.

EXPLANATORY NOTE

(This note is not part of the Instrument and does not purport to be a legal interpretation)

These Regulations set out Community standards and specifications relating to a quality system for blood establishments for the purpose of giving effect to Directive 2005/62/ EC.

SCHEDULE

Quality system standards and specifications

1. INTRODUCTION AND GENERAL PRINCIPLES

1.1. Quality system

1.   Quality shall be recognised as being the responsibility of all persons involved in the processes of the blood establishment with management ensuring a systematic approach towards quality and the implementation and maintenance of a quality system.

2.   The quality system encompasses quality management, quality assurance, continuous quality improvement, personnel, premises and equipment, documentation, collection, testing and processing, storage, distribution, quality control, blood component recall, and external and internal auditing, contract management, nonconformance and self-inspection.

3.   The quality system shall ensure that all critical processes are specified in appropriate instructions and are carried out in accordance with the standards and specifications set out in this Schedule. Management shall review the system at regular intervals to verify its effectiveness and introduce corrective measures if deemed necessary.

1.2. Quality assurance

1.   All blood establishments and hospital blood banks shall be supported by a quality assurance function, whether internal or related, in fulfilling quality assurance. That function shall be involved in all quality-related matters and review and approve all appropriate quality related documents.

2.   All procedures, premises, and equipment that have an influence on the quality and safety of blood and blood components shall be validated prior to introduction and be re-validated at regular intervals determined as a result of these activities.

2. PERSONNEL AND ORGANISATION

1.   Personnel in blood establishments shall be available in sufficient numbers to carry out the activities related to the collection, testing, processing, storage and distribution of blood and blood components and be trained and assessed to be competent to perform their tasks.

2.   All personnel in blood establishments shall have up to date job descriptions which clearly set out their tasks and responsibilities. Blood establishments shall assign the responsibility for processing management and quality assurance to different individuals who function independently.

3.   All personnel in blood establishments shall receive initial and continued training appropriate to their specific tasks. Training records shall be maintained. Training programmes shall be in place and shall include good practice.

4.   The contents of training programmes shall be periodically assessed and the competence of personnel evaluated regularly.

5.   There shall be written safety and hygiene instructions in place adapted to the activities to be carried out, which are in compliance with Council Directive 89/391/EEC ¹ and Directive 2000/54/EC of the European Parliament and of the Council² .

3. PREMISES

3.1. General

Premises including mobile sites shall be adapted and maintained to suit the activities to be carried out. They shall enable the work to proceed in a logical sequence so as to minimise the risk of errors, and shall allow for effective cleaning and maintenance in order to minimise the risk of contamination.

3.2. Blood donor area

There shall be an area for confidential personal interviews with and assessment of individuals to assess their eligibility to donate. This area shall be separated from all processing areas.

3.3. Blood collection area

Blood collection shall be carried out in an area intended for the safe withdrawal of blood from donors, appropriately equipped for the initial treatment of donors experiencing adverse reactions or injuries from events associated with blood donation, and organised in such a way as to ensure the safety of both donors and personnel as well as to avoid errors in the collection procedure.

3.4. Blood testing and processing areas

There shall be a dedicated laboratory area for testing that is separate from the blood donor and blood component processing area with access restricted to authorised personnel.

3.5. Storage area

1.   Storage areas shall provide for properly secure and segregated storage of different categories of blood and blood components and materials including quarantine and released materials and units of blood or blood components collected under special criteria (e.g. autologous donation).

2.   Provisions shall be in place in the event of equipment or power failure in the main storage facility.

3.6. Waste disposal area

An area shall be designated for the safe disposal of waste, disposable items used during the collection, testing, and processing and for rejected blood or blood components.

4. EQUIPMENT AND MATERIALS

1.   All equipment shall be validated, calibrated and maintained to suit its intended purpose. Operating instructions shall be available and appropriate records kept.

2.   Equipment shall be selected to minimise any hazard to donors, personnel, or blood components.

3.   Only reagents and materials from approved suppliers that meet the documented requirements and specifications shall be used. Critical materials shall be released by a person qualified to perform this task. Where relevant, materials, reagents and equipment shall meet the requirements of Council Directive 93/42/EEC¹ for medical devices and Directive 98/79/EC of the European Parliament and of the Council² for in vitro diagnostic medical devices or comply with equivalent standards in the case of collection outside the European Community.

4.   Inventory records shall be retained for a period acceptable to and agreed with the Irish Medicines Board.

5.   When computerised systems are used, software, hardware and back-up procedures must be checked regularly to ensure reliability, be validated before use, and be maintained in a validated state. Hardware and software shall be protected against unauthorised use or unauthorised changes. The back-up procedure shall prevent loss of or damage to data at expected and unexpected down times or function failures.

5.        DOCUMENTATION

1.   Documents setting out specifications, procedures and records covering each activity performed by the blood establishment shall be in place and kept up to date.

2.   Records shall be legible and may be handwritten, transferred to another medium such as microfilm or documented in a computerised system.

3.   All significant changes to documents shall be acted upon promptly and shall be reviewed, dated and signed by a person authorised to perform this task.

6. BLOOD COLLECTION, TESTING AND PROCESSING

6.1. Donor eligibility

1.   Procedures for safe donor identification, suitability interview and eligibility assessment shall be implemented and maintained. They shall take place before each donation and comply with the requirements set out in Regulation 9 (2) of SI No 360 of 2005 .

2.   The donor interview shall be conducted in such a way as to ensure confidentiality.

3.   The donor suitability records and final assessment shall be signed by a qualified health professional.

6.2. Collection of blood and blood components

1.   The blood collection procedure shall be designed to ensure that the identity of the donor is verified and securely recorded and that the link between the donor and the blood, blood components and blood samples is clearly established.

2.   The sterile blood bag systems used for the collection of blood and blood components and their processing shall be CE-marked or comply with equivalent standards if the blood and blood components are collected outside the European Community. The batch number of the blood bag shall be traceable for each blood component.

3.   Blood collection procedures shall minimise the risk of microbial contamination.

4.   Laboratory samples shall be taken at the time of donation and appropriately stored prior to testing.

5.   The procedure used for the labelling of records, blood bags and laboratory samples with donation numbers shall be designed to avoid any risk of identification error and mix-up.

6.   After blood collection, the blood bags shall be handled in a way that maintains the quality of the blood and at a storage and transport temperature appropriate to further processing requirements.

7.   There shall be a system in place to ensure that each donation can be linked to the collection and processing system into which it was collected and/or processed.

6.3. Laboratory testing

1.   All laboratory testing procedures shall be validated before use.

2.   Each donation shall be tested in conformity with the requirements laid down in Regulations 9 (3) (a) (i), 9 (3) (a) (ii), 9 (7) and 9 (8) of S.I. No. 360 of 2005 .

3.   There shall be clearly defined procedures to resolve discrepant results and ensure that blood and blood components that have a repeatedly reactive result in a serological screening test for infection with the viruses mentioned in Regulation 9 (7) (c) of SI 360 of 2005 shall be excluded from therapeutic use and be stored separately in a dedicated environment. Appropriate confirmatory testing shall take place. In case of confirmed positive results, appropriate donor management shall take place including the provision of information to the donor and follow-up procedures.

4.   There shall be data confirming the suitability of any laboratory reagents used in the testing of donor samples and blood component samples.

5.   The quality of the laboratory testing shall be regularly assessed by the participation in a formal system of proficiency testing, such as an external quality assurance programme.

6.   Blood group serology testing shall include procedures for testing specific groups of donors (e.g. first time donors, donors with a history of transfusion).

6.4. Processing and validation

1.   All equipment and technical devices shall be used in accordance with validated procedures.

2.   The processing of blood components shall be carried out using appropriate and validated procedures including measures to avoid the risk of contamination and microbial growth in the prepared blood components.

6.5. Labelling

1.   At all stages, all containers shall be labelled with relevant information of their identity. In the absence of a validated computerised system for status control, the labelling shall clearly distinguish released from non-released units of blood and blood components.

2.   The labelling system for the collected blood, intermediate and finished blood components and samples must unmistakably identify the type of content, and comply with the labelling and traceability requirements referred to in Regulation 10 of SI No 360 of 2005 and SI No. 547 of 2006 . The label for a final blood component shall comply with the requirements of Regulation 10 of SI No 360 of 2005 .

3.   For autologous blood and blood components, the label also shall comply with Regulation 9 (1) (j) of SI No 360 of 2005 .

6.6. Release of blood and blood components

1.   There shall be a safe and secure system to prevent each single blood and blood component from being released until all mandatory requirements set out in these Regulations have been fulfilled. Each blood establishment shall be able to demonstrate that each blood or blood component has been formally released by an authorised person. Records shall demonstrate that before a blood component is released, all current declaration forms, relevant medical records and test results meet all acceptance criteria.

2.   Before release, blood and blood components shall be kept administratively and physically segregated from released blood and blood components. In the absence of a validated computerised system for status control the label of a unit of blood or blood component shall identify the release status in accordance with 6.5.1.

3.   In the event that the final component fails release due to a confirmed positive infection test result, in conformity with the requirements set out in 6.3.2 and 6.3.3, a check shall be made to ensure that other components from the same donation and components prepared from previous donations given by the donor are identified. There shall be an immediate update of the donor record.

7. STORAGE AND DISTRIBUTION

1.   The quality system of the blood establishment shall ensure that, for blood and a blood components intended for the manufacture of medicinal products, the storage and distribution requirements shall comply with Directive 2003/94/EC¹ .

2.   Procedures for storage and distribution shall be validated to ensure blood and blood component quality during the entire storage period and to exclude mix-ups of blood components. All transportation and storage actions, including receipt and distribution, shall be defined by written procedures and specifications.

3.   Autologous blood and blood components as well as blood components collected and prepared for specific purposes shall be stored separately.

4.   Appropriate records of inventory and distribution shall be kept.

5.   Packaging shall maintain the integrity and storage temperature of blood or blood components during distribution and transportation.

6.   Return of blood and blood components into inventory for subsequent reissue shall only be accepted when all quality requirements and procedures laid down by the blood establishment to ensure blood component integrity are fulfilled.

8. CONTRACT MANAGEMENT

Tasks that are performed externally shall be defined in a specific written contract.

9. NON-CONFORMANCE

9.1. Deviations

Blood components deviating from required standards set out in Regulation 9 (3) (c) of SI No 360 of 2005 shall be released for transfusion only in exceptional circumstances and with the recorded agreement of the prescribing physician and the blood establishment physician.

9.2. Complaints

All complaints and other information, including serious adverse reactions and serious adverse events, which may suggest that defective blood components have been issued, shall be documented, carefully investigated for causative factors of the defect and, where necessary, followed by recall and the implementation of corrective actions to prevent recurrence. Procedures shall be in place to ensure that the Irish Medicines Board is notified as appropriate of serious adverse reactions or serious adverse events in accordance with regulatory requirements.

9.3. Recall

1.   There shall be personnel authorised within the blood establishment to assess the need for blood and blood component recall and to initiate and coordinate the necessary actions.

2.   An effective recall procedure shall be in place, including a description of the responsibilities and actions to be taken. This shall include notification to the Irish Medicines Board.

3.   Actions shall be taken within pre-defined periods of time and shall include tracing all relevant blood components and, where applicable, shall include trace-back. The purpose of the investigation is to identify any donor who might have contributed to causing the transfusion reaction and to retrieve available blood components from that donor, as well as to notify consignees and recipients of components collected from the same donor in the event that they might have been put at risk.

9.4. Corrective and preventive actions

1.   A system to ensure corrective and preventive actions on blood component non-conformity and quality problems shall be in place.

2.   Data shall be routinely analysed to identify quality problems that may require corrective action or to identify unfavourable trends that may require preventive action.

3.   All errors and accidents shall be documented and investigated in order to identify system problems for correction.

10. SELF-INSPECTION, AUDITS AND IMPROVEMENTS

1.   Self-inspection or audit systems shall be in place for all parts of the operations to verify compliance with the standards set out in this Schedule. They shall be carried out regularly by trained and competent persons in an independent way according to approved procedures.

2.   All results shall be documented and appropriate corrective and preventive actions shall be taken in a timely and effective manner.

¹ OJ L 183, 29.6.1989, p.1.

² OJ L262, 17.10.2000, p.21.

¹ OJ L 169, 12.7.1993, p.1 Directive as last amended by Regulation (EC) No. 1882/2003 of the European Parliament and of the Council (OJ L 284, 31.10.2003, p.1).

² OJ L 331, 7.12.1998, p.1 Directive as amended by Regulations (EC) No.1882/2003.

¹ OJ L262, 14.10.2003, p.22.