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The New Solution to Reprocessing: Decontamination, Inspection, Cleaning and Sterilization

Reprocessing is a relatively new critical discipline that requires a multidisciplinary approach. After a surgical procedure the instrument needs to be processed such that it is suitable for safe reuse in a patient. The basic requirement is that the instrument meets all of its design specifications as well as being clean and sterile. Each instrument needs to be cleaned and sterilized. After an initial decontamination the instrument must be inspected to make sure it is in good repair.

Unfortunately, the instructions supplied by manufactures are sometimes vague. In our laboratory we carefully design experiments to prove that the instrument is clean to a very high level. Therefore instructions for cleaning can be written that are clear and precise. For example, after challenging the instrument with artificial soil in a very extreme manner we can demonstrate that after either a manual or automated cleaning process the soil is reduced by 99.8 to 99.9% using precise, validated analytical tests for protein and total organic carbon.

One of the major issues facing health care facilities today is the ability to provide quick, efficient turnaround time for reprocessing of their surgical and diagnostic instruments. Cost, reliability and validation of the materials involved can be a constant headache to hospital administrators and their technical staff, and draws away critical personnel from their key function, the health of the patient.

Gibraltar Laboratories provides a cost effective, validated process for pickup, sterilization and return of key instruments to health care facilities throughout the area. Nightly pickup service, with overnight sterilization and morning return keeps the process of high quality health care on track at our clients’ facilities. Our validated sterilization program, performed under FDA CGMP guidelines, means you have the assurance that all critical testing issues have been addressed, and your patients’ health is in no way compromised. Those instruments found to not meet with the mechanical specifications you set are segregated from the tray, and returned to you for corrective action, without delaying the cleaning, sterilization cycle.

Let Gibraltar become your source for efficient and timely turnaround of this critical function. Call us at 973-227-6882. Our staff is there to answer your needs.

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2011 Holiday Party-New Services

We celebrated together on December 16, 2011 enjoying a great meal and especially our talented performers. We have posted pictures and videos on our Facebook and YouTube pages. You are invited to look at them.

As the year comes to the end we have much to be grateful for. We continue to grow and expand our services to now include sterilization of medical instruments and trays including training. There is a great need to support central services and Gibraltar is perfectly suited to meet this need with six large steam sterilizers and professional disinfectant/washer. We also provide training and certification in decontamination.

We also help manufacturers validate that their single use instruments or trays meet FDA guidelines such as: ANSI/AAMI ST79:201 & A1:2010 Comprehensive guide to steam sterilization and sterility assurance in health care facilities, ANSI/AAMI ST81:2004/®2010 – Sterilization of medical devices – information to be provided by the manufacturer for the processing of resterilizable medical devices, AAMI TIR12:2010 – Designing, testing, and labeling reusable medical devices for reprocessing in health care facilities: A guide for medical device manufactures, ANSI/AAMI ST77:2006 – Containment devices for reusable medical device sterilization, AAMI TIR30:2011 – A compendium of processes, materials, test methods, and acceptance criteria for cleaning reusable medical devices, EN 868-8:2009 – Packaging materials for terminally sterilized medical devices Part 8: Re-usable sterilization containers for steam sterilizers conforming to EN 285 – Requirements and test methods. European Committee for Standardization, Brussels, Belgium.

Instruments and trays must not only be sterile but also must be dry as demonstrated under worst case conditions. Related to this we perform cleaning validations utilizing artificial soil and worst case conditions. This work is critical to support the the instructions for use. Our service includes both professional protocol and final report preparation.

As we enter our 42 year all of us  at GBL again wish to say thanks to all of you that have helped make us so successful for so many years! We are excited to continue to support your critical needs in the excellent and extraordinary manner that we are known for. We wish you all a very happy and healthy Holiday Season!

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USP Viral Clearance and Test Methodologies

Virology test methods are increasingly important for the assessment of safety and effectiveness of medical treatments. For example, the development of biological (biologics and biotechnology-derived) products and therapies for human or animal use has created the need for sensitive viral detection assays for use in the GMP production and testing of biological products. This need is not limited to the production of viral vaccines, but also applies to the development and manufacture of recombinant proteins, cell and gene therapies, and other products.

 

The purpose of the virology test methods is for quality control testing of a variety of raw materials and processing reagents of animal origin used to manufacture biological products that have varying potential for introducing viral contaminants.  According to USP <1237>  VIROLOGY TEST METHODS,

 

“The production of biological products may allow the replication of adventitious agents during processing, and therefore these materials must be prescreened to avoid the opportunity for contamination of the product. Another point to consider regarding screening these materials is that the product may not be compatible with processing methods used to eliminate or inactivate these adventitious agents. Because of the nature of the biological products, the production process needs to include appropriate testing regimens that monitor the possible introduction of adventitious agents and/or viral agents into the systems used. For these reasons, sensitive viral detection methods are required not only for the release testing of biological drug products, but also during the intermediate stages of processing, process development, and routine manufacture. Important stages for consideration include the development of cell substrates and banks, raw materials of animal origin, process intermediates, and critical excipients when derived from animal tissues. This strategy should be augmented with viral clearance and inactivation studies whenever possible.”

 

There are several aspects to virology testing and all of them are complex requiring expert knowledge and sophisticated laboratories. In the purest sense one demonstrates the presence of a virus by growing it in a host such as cell culture, chicken embryo, or an animal [e.g., mouse, duck, rhesus monkey]. Infectious virus particles contaminating biologics and biotechnology-derived products are of great safety concern, because they have the potential for causing serious, possibly life-threatening, infections in the patients treated. This is particularly true if the patients are immunocompromised.

 

The purpose of a viral clearance study is to obtain assurance that a significant safety margin can be established through viral detection methods applied to unprocessed bulk and raw materials before purification in combination with purification processes that demonstrate the ability to inactivate or remove potential viral contaminants present at levels too low to detect. (See Viral Safety Evaluation of Biotechnology Products Derived from Cell Lines of Human or Animal Origin <1050> for information on viral clearance and inactivation methods.)

 

Careful sample preparation is critical to validate viral clearance because the virus that one wants to demonstrate being cleared may be labile. Therefore, sample preparation typically involves storage of test samples at low temperatures (ideally -60 or below) as soon as practicable upon collection. When intended for use in a viral screening assay, aliquots of samples should be prepared to avoid multiple freezing and thawing. Samples intended for viral infectivity assays are typically shipped with sufficient dry ice to last several days more than the expected time required for transit. When received at the testing laboratory, the sample should be examined to verify that it is still frozen, and appropriate documentation should be completed. For any storage or hold condition, the impact of the condition on viral viability should be empirically assessed and sufficient cold chain management ensured.

Typical sample types for viral detection assays are:

  • Cell Lysates— Test samples derived from cell substrates (master and working cell banks, end-of-production cell samples) are prepared in a manner that allows sampling of both the cells (for cell-associated viruses) and the conditioned medium (for virus shed into the medium). To achieve this, a culture of the cells is sampled. A cell suspension of ~107 cells per mL in conditioned medium is prepared and frozen (ideally at -60 or below). Because this medium does not contain cryopreservative, the majority of the cells will lyse upon thawing of the sample, releasing the cell-associated virus. Low-speed centrifugation will remove larger cellular debris and yield a supernatant that may be inoculated directly onto detector cells in cell-based viral infectivity assays.

 

  • Biotechnology Bulk Harvest (Unprocessed Bulk Harvest) Samples— Routine lot testing of bulk harvest samples is mandatory for most types of biologics.

 

  • Raw Materials of Animal Origin— Ingredients of animal origin used in the manufacture of biological products for human or veterinary use must be tested for species-specific viruses of concern as described in 9 CFR 113.53. The raw materials may be stored under a variety of conditions, as appropriate to the raw material. Sample preparation and method of application to the test system depend on the nature of the sample.

 

Gibraltar has considerable expert knowledge in the classical and molecular procedures necessary to achieve compliance. We have published many papers[1] and maintains one of the private largest repositories of cells and viruses for the above purposes.

 


[1] “The Principles of Viral Control and Transmission”; Herbert N Prince, Daniel L. Prince, Richard N. Prince; Disinfection, Sterilization and Preservation, 4th Edition; 1991;

“Quality Assurance of Monoclonal Products: Virologic and Molecular Biologic Consideration”; Daniel L. Prince, Richard N. Prince; Journal of Industrial Microbiology, 3 (1988) 157-165; 1988 (MV); ” Methodological Approaches to Disinfection of Human Hepatitis B Virus”; D.L. Prince, H,N. Prince; O. Thraenhart, E. Muchmore, Ebonder, J. Pugh; Journal of Clinical Microbiology, P.3296-3304;Dec.93;

Prince et al.  (2011)  “Relationship of subtype influenza A pandemic strains to virucidal activity of a quaternary ammonium disinfectant.”  Influenza and Other Respiratory Viruses 5 (Suppl. 1), 301-327.

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Regulations get stricter and stricter for Dietary Supplement Industry

Gibraltar Laboratories Dietary Supplement Program

The Food and Drug Administration has recently defined its regulations for the Dietary Supplement Industry. These regulations place that industry under current Good Manufacturing Practices (CGMP) guidelines. This step, designed to assure a consistency of quality throughout the manufacturing and release of those products, has placed a greater responsibility upon those manufacturers.

Gibraltar Laboratories, a world renowned independent laboratory working under the same CGMP guidelines, has developed programs to meet with the federal guidelines. These programs are designed to help companies both new to the guidelines and those with quality systems already in place.

Some of the fundamental requirements that Dietary supplement manufactures may not be accustomed to are listed below. All of the below elements must be carefully documented and reviewed.

1 Vendor qualification

How do you handle domestic and international vendors under CGMP guidance?

2. Specification development programs

How do you determine what your raw material must have?

3. Raw Material analysis

Do your raw materials meet your specifications? What do you do when they don’t?

4. Analytical analysis of final products

Is what you have manufactured really what you want?

5. Microbiological analysis of final products

How do you control microbiological contamination in natural products?

5.  Stability and shelf life (expiration dating) determination

How do you assure that your product will last once it is in the field?

6. CGMP consultation

Do you have a strong enough quality/regulatory program?

For help or more information in any of the above please contact us at 973.227.6882.

 

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Bacterial Identification

Gibraltar Laboratories helps its sponsors control microbial contamination in
the manufacturing environment. Raw material and finished products are
usually subject to a compendia and/or sponsor specification with respect to
what organisms, if any, can be present. Microbial identification is the
science of correctly identifying by name the organism[s] present. By knowing
what organisms are present it is possible to design control measures to
control them. These microbial control measures can then be verified for
effectiveness by monitoring [e.g. Bioburden testing, environmental air
sampling, cleaning validations, etc.] Clinically, precise bacterial
identification and pathogen detection is necessary for correct disease
diagnosis, treatment of infection and trace-back of disease outbreaks
associated with microbial infections. Bacterial identification is used in a
wide assortment of applications including microbial forensics, criminal
investigations, bio-terrorism threats and environmental studies. At
Gibraltar Laboratories microbial identification is based on assortment of
characteristics including, phenotypic, biochemical and genetic.

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Mycoplasma Testing

 

Mycoplasma, like Mycoplasma pneumoniae, are microbial parasites that infect mammalian cells causing sickness in humans and many other animal species Biological and biotechnology companies must be very vigorous and alert to control Mycoplasma. If not. millions of dollars and months of work can be wasted . Thus. mycoplasma Testing, the testing of cell cultures for mycoplasma, is a critical step in ensuring dependable research and biotechnology products. Mycoplasma are prokaryotic microorganisms and are typically resistant to many antibiotics. Mycoplasma grow in close association with cells and can modify cell characteristics. Mycoplasma are difficult to detect unless routine monitoring of cell stocks is carried out, but with Gibraltar Laboratories’ Mycoplasma Testing DNA staining and direct culture methods are performed concurrently for each sample. Together these methods can detect mycoplasma infection for most of the known species. Each mycoplasma test includes positive and negative controls and complete testing requires four to five weeks. The specific tests available at Gibraltar Laboratories are defined in the United States Pharmocopeia  <63> Mycoplasma Tests, Code of Federal Regulations, 9 CFR 113.28 MYCOPLASMA TEST and 21 CFR 610.30 MYCOPLASMA TEST. In addition, the latest breakthrough in Mycoplasma detection is by polymerase chain reaction. This molecular biology test is great for rapid, cost effective testing.

Gibraltar Laboratories is your testing lab of choice for mycoplasma testing and many other laboratory services. For a complete list of our testing services, please click here http://www.gibraltarlabsinc.com/component/option,com_service_search/Itemid,28/lang,en/view,blist/.

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Virus testing Capabilites

Validation of a biological manufacturing process requires that adventitious viral contaminants be destroyed or purified from the final product.  Of concern are a variety of viruses which may originate from non-human animal ingredients such as serum. Of course human viruses such as HBV and HIV are also of concern. In other words manufacturers of  products derived from animal or human tissues, blood products and some medical devices are required to assess the ability of their purification and manufacturing processes to produce a product that is safe for use in humans. Gibraltar Laboratories performs the studies which are intended to provide empirical evidence of the effectiveness of the critical steps of the manufacturing process  to inactivate or remove viruses. Such validation requires highly specialized facilities and staff  to carefully perform.  Without a successful validation regulatory authorities such as the FDA do not feel there is enough safety data to allow approval  of an investigational new drug (IND) submission for human use. Gibraltar Laboratories has a secure collection of many important challenge viruses that demonstrate effectiveness when the mechanism  of action is heat or chemical For example. Bovine Diarrheal Virus, Polio Viruses, Adeno Virus, Parvo viruses,  DHBV, Herpes simplex virus type 1 or 2, Human Immunodeficiency virus 1, Human rhinovirus, Equine Influenza, Porcine parvovirus, Pseudorabies, Reovirus type 3 Simian virus 40, Sindbis virus,  Transmissible gastroenteritis virus , Vaccina virus and Vesicular stomatitis virus.

In each critical step Gibraltar Laboratories determines the log reduction value. We hope that our sponsor’s process will be highly effective having an overall log reduction value of 4-6 logs or more! The removal of prion like agents is an additional consideration that is sometimes needed and can be discussed separately, i.e., transmissible spongiform encephalopathy (TSE) agents.

Gibraltar also performs viral experiments to demonstrate the in vitro effectiveness of anti-viral drugs and disinfectants intended as research or support regulatory submissions to US FDA and EPA.

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Sterilty Testing

The Sterility Test specified in USP General Chapter <71>  is understood to mean that pathogenic bacteria, yeast and/or fungi are absent from the article labeled “sterile”. In the United States, Europe, Japan, Australia and Canada the word “sterile” has that legal meaning. We don’t often think that we live in an environment surrounded by millions and billions of invisible microorganisms. The vast majority of them do not make us sick and in fact we could not live on earth today without them. However, pathogens like E.coli or Pseudomonas or Salmonella or Mycoplasma can and do make us sick, especially if we are older, infirmed or immunocompromised.  Recently the methodology used to determine if an article labeled sterile is sterile (sterility testing) was  harmonized amongst the United States, European and Japanese Pharmacopoeias.  In our blog about USP Monographs, we mentioned that a USP  monograph defines specific quality attributes. USP monographs which contain the “sterile” attribute must meet the requirements of sterility as defined in Chapter 71. For example,  Sterile Water for Injection is prepared from Water for Injection that is sterilized and suitably packaged. It contains no antimicrobial agent or other added substance. Thus, sterility Testing is the official referee test to determine legally if an article is sterile or not. An article labeled sterile is manufactured by a process that itself is validated to be effective with a very high degree of probability. This concept is known as the sterilization assurance level [SAL]. The current state of the art is a SAL of one in one million meaning that not more than one article of one million is likely to be non-sterile if a successfully validated process was followed.

Gibraltar Laboratories conducts the membrane filtration test using the Millipore Steritest system and the direct inoculation method in an ISO Class 5 sterility suite. In both methods the samples are placed in Soybean Casein Digest Medium (SCDM) and Fluid Thioglycollate Medium (FTM) and incubated for 14 days.  The samples are observed for evidence of microbial contamination daily. Gibraltar Laboratories also is expert in special sterility applications such as defined in ST 79 involving challenge with relatively resistant spores to steam sterilization. Gibraltar is expert in defining the protocol to validate the steam sterilization process including Installation Qualification, Operational Qualification and Performance Qualification.

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USP Monographs

The United States Pharmacopeia (USP) is a non–governmental, official public standards–setting authority for prescription and over–the–counter medicines and other healthcare products manufactured or sold in the United States. USP also sets widely recognized standards for food ingredients and dietary supplements. USP sets standards for the quality, purity, strength, and consistency of these products–critical to the public health. USP’s standards are recognized and used in more than 130 countries around the globe. These standards have helped to ensure public health throughout the world for close to 200 years. USP Monographs are standards that specify the quality attributes of thousands of ingredients, raw materials excipients and finished products sold in the United States. These standards are recognized as official by the United States Food and Drug Administration. An example of a USP Monograph is Aspirin.

The nine quality attributes that must be certified by qualified laboratories such as Gibraltar Laboratories are listed below

USP Aspirin

C9H8O4 180.16

  1. Identification—
  2. Loss on drying 731
  3. Readily carbonizable substances 271
  4. Residue on ignition 281:
  5. Chloride 221—
  6. Sulfate
  7. Heavy metals
  8. Limit of free salicylic acid
  9. Assay
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Bacterial Identification

Gibraltar Laboratories helps its sponsors control microbial contamination in
the manufacturing environment. Raw material and finished products are
usually subject to a compendia and/or sponsor specification with respect to
what organisms, if any, can be present. Microbial identification is the
science of correctly identifying by name the organism[s] present. By knowing
what organisms are present it is possible to design control measures to
control them. These microbial control measures can then be verified for
effectiveness by monitoring [e.g. Bioburden testing, environmental air
sampling, cleaning validations, etc.] Clinically, precise bacterial
identification and pathogen detection is necessary for correct disease
diagnosis, treatment of infection and trace-back of disease outbreaks
associated with microbial infections. Bacterial identification is used in a
wide assortment of applications including microbial forensics, criminal
investigations, bio-terrorism threats and environmental studies. At
Gibraltar Laboratories microbial identification is based on assortment of
characteristics including, phenotypic, biochemical and genetic.

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