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Friday, July 9, 2010

Med Prep Consulting, Inc 7/9/10

 

Department of Health and Human Services' logoDepartment of Health and Human Services

Public Health Service
Food and Drug Administration
 Parsippany, New Jersey 07054
(973) 331-49024

July 9, 2010

WARNING LETTER

CERTIFIED MAIL
RETURN RECEIPT REQUESTED

Gerald R. Tighe, President
Med Prep Consulting, Inc.
1540 West Park Avenue, Suite 5
Tinton Falls, New Jersey 07712

Dear Mr. Tighe:

10- NWJ-13

During the period of December 1-8, 2009, U.S. Food and Drug Administration (FDA) investigators conducted an inspection at your facility known as Med Prep Consulting Inc., located at 1540 West Park Avenue, Suite 5, Tinton Falls, NJ 07712. The inspection revealed that your firm repackages sterile drug products. According to a document collected during the recent inspection, it appears that your firm enters into a "Repackaging Services Agreement" with its clients. This agreement demonstrates your firm's practice of repackaging sterile drug products for other entities, including hospital pharmacies, without a prescription from a licensed practitioner. FDA does not consider your practice of repackaging and distributing drugs without patient-specific prescriptions to constitute the regular course of a pharmacy's business of dispensing and selling drugs at retail.

FDA regards mixing, packaging, and other manipulations of approved drugs by licensed pharmacists, consistent with the approved labeling of the product and pursuant to prescriptions for identified patients, to be within the practice of pharmacy. Processing and repacking (including repackaging) of approved drugs for resale by other pharmacies or entities, however, exceeds the traditional practice of pharmacy. Consequently, your firm is Subject to the current Good Manufacturing Practice (cGMP) requirements for drugs as described in section 501(a)(2)(B) of the FDCA [21 U.S.C. § 351 (a)(2)(B)] and 21 CFR parts 210 and 211. The cGMP regulations applicable to repackagers help prevent drug product mix-ups and contamination, among other potential public health hazards. In addition, these regulations require assurances about the stability of repackaged drug products from the time the drug is repackaged until it is actually dispensed to a patient.

FDA is particularly concerned about the manipulation of sterile drug products when a sterile container is opened or otherwise entered to conduct manipulations. The moment a sterile container is opened and manipulated, a quality standard (sterility) is destroyed and previous studies supporting the standard are compromised and are no longer valid. We are especially concerned with the potential microbial contamination associated with splitting single-use, preservative-free, vials into multiple doses. Drugs that are not repackaged according to cGMP requirements are adulterated under section 501(a)(2)(B) of the FDCA [21 U.S.C. § 351(a)(2)(B)].

Because of your repackaging practices, section 510 of the FDCA [21 U.S.C. § 360] requires you to register with FDA and submit a listing of all of the drugs that you are repackaging. Until these requirements are met, drugs that are repackaged by your firm are also misbranded under section 502(o) of the FDCA [21 U.S.C. § 352(o)].

Section 301(a) of the FDCA [21 U.S.C. § 331 (a)] prohibits the introduction or delivery for introduction into interstate commerce of any adulterated or misbranded drug. In addition, section 301(k) of the FDCA [21 U.S.C. § 331(k)] prohibits any act with respect to a drug if the act is done while the drug is held for sale after shipment in interstate commerce and results in the drug being adulterated or misbranded.

It is your responsibility to ensure that your firm complies with all requirements of federal law and FDA regulations.

You should take prompt action to correct the violations cited in this letter. Failure to promptly correct these violations may result in legal action without further notice, including, without limitation, seizure and injunction. Other federal agencies may take this Warning Letter into account when considering the award of contracts.

Within fifteen working days of receipt of this letter, please notify this office in writing of the specific steps that you have taken to correct the cited violations. Include an explanation of each step being taken to prevent the recurrence of violations, as well as copies of related documentation. If you cannot complete corrective action within fifteen working days, state the reason for the delay and the time within which you will complete the correction.

Address your reply to the following address: U.S. Food and Drug Administration, 10 Waterview Blvd, 3rd floor, Parsippany, NJ 07054, Attention: Sarah A. Della Fave, Compliance Officer.

Sincerely,

/s/

Diana Amador Toro
Director
New Jersey District
U.S. Food and Drug Administration

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Thursday, July 8, 2010

Florida Bottling, Inc.

  

Department of Health and Human Services logoDepartment of Health and Human Services

Public Health Service
Food and Drug Administration
 555 Winderley Pl., Ste. 200
Maitland, FL 32751
 


CERTIFIED MAIL
RETURN RECEIPT REQUESTED

WARNING LETTER

FLA-10-24
 

July 8, 2010
 

Mr. Thomas R. Fuhnnan
Florida Bottling, Inc
1035 NW 21st Terrace
Miami, FL 33127
 

Dear Mr. Fuhnnan:

The U.S. Food and Drug Administration (FDA) inspected your facility located at 1035 NW 21st Terrace, Miami, FL 33127 and established that your firm manufactures and distributes beverage products. The FDA also reviewed your website at www.lakewoodjuices.com in June 2010 and have determined that this site constitutes labeling under section 201(m) of the Federal Food, Drug and Cosmetic Act (the Act). The FDA has determined that your Fresh Pressed Blueberry Blend, Pure Aloe, Pure Pomegranate (organic), and Tart Cherry juice products are in violation of the Act. You may find the Act and the Code of Federal Regulations for Food Labeling at FDA's home page at www.fda.gov.
 

Unapproved New Drug

Your product labels and your websites at www.lakewoodjuices.com and www.floridabottling.com, promote your juice beverage products for conditions that cause them to be drugs under section 201(g)(1) of the Act [21 U.S.C. § 321(g)(1)]. The therapeutic claims on your website establish that the products are drugs because they are intended for use in the cure, mitigation, treatment, or prevention of disease. The marketing of these products with these claims violates the Act. Examples of some of the disease claims on your product labels and observed on your website include:
 

Fresh Pressed Blueberry Blend label and webpage:
 

• "[R]educes infections"

 

Pure Pomegranate (organic) label and webpage:
 

• "Powerful antioxidant with anti-adhesion effects to fight artherosclerosis [sic]"
• "Ellagic acid to help inhibit the growth of cancer cells"
 

Pure Aloe:
 

• Label:
 

o "Reduce Swelling in Joints"
o "Healing Bums and Wounds"
o "Effective Skin Emollient with Antibacterial, Antifungal and Antiviral Properties"
 

• Website:
 

o "Drinking aloe vera juice can aid in the healing of ... ulcers ...."
 

Tart Cherry label and webpage:
 

• "Reduce the Pain of Arthritis, Gout ..."
 

Your products are not generally recognized as safe and effective for the above referenced, uses; therefore, the products are "new drugs" under section 201(P) of the Act [21 U.S.C. § 321(P)]. New drugs may not be legally marketed in the US. without prior approval from the FDA, as described in section 505(a) of the Act [21 U.S.C. § 355(a)]. FDA approves a new drug on the basis of scientific data submitted by a drug sponsor to demonstrate that the drug is safe and effective. In addition, your products are offered for conditions that are not amenable to self-diagnosis and treatment by individuals who are not medical practitioners; hence, adequate directions for use cannot be written so that a layperson can use these drugs safely for their intended use. Therefore, your products are also misbranded within the meaning of section 502(f)(1) of the Act, in that the labeling for these drugs fails to bear adequate directions for use [21 U.S.C. § 352(f)(1)].
 

Unauthorized Health Claims
 

Even if your product labeling did not include claims that cause your products to be drugs, your Fresh Pressed Blueberry Blend and Tart Cherry juice beverage products are misbranded foods under section 403(r)(1)(B) of the Act [21 US.C. § 343(r)(1)(B)] because the labeling bears unauthorized health claims. Your product labels and your website, www.lakewoodjuices.com. were reviewed and were found to contain a number of unauthorized health claims, including:
 

Fresh Pressed Blueberry Blend label and webpage:
 

• "Heart Healthy"
• "Reduction of risk factors related to Cancer, Heart Disease, Stroke & Alzheimer's"
 

Tart Cherry label and webpage:
 

• "Heart Healthy"
• "Reduce the Risk Factors Related to Heart Disease"
 

The claim "heart healthy" is an implied health claim that characterizes that relationship between these juice products and reduced risk of heart disease. All of the above claims are unauthorized health claims because there is no health claim authorized by regulation or the Act that provides for health claims that characterize the relationship between these juice products and heart disease, cancer, stroke, or Alzheimer's disease.
 

Unauthorized Nutrient Content Claims
 

Under section 403(r)(1)(A) of the Act [21 U.S.C. § 343(r)(1)(A)], a claim that characterizes the level of a nutrient which is of the type required to be in the labeling of the food must be made in accordance with a regulation promulgated by the Secretary. (and, by delegation, FDA) authorizing the use of such a claim. The use of a term not defined by regulation in food labeling to characterize the level of a nutrient misbrands a product under section 403(r)(1)(A) of the Act.
 

Nutrient content claims using the terms "high," "rich in," or "excellent source of" may be used on the label and in the labeling of foods provided that the food contains 20 percent or more of the reference daily intake (RDI) or the daily reference value (DRV) per reference amount customarily consumed (RACC) [21 CFR 101.54(b)(1)]. Therefore, claims made on the label and website for your Pure Aloe juice beverage product are unauthorized nutrient content claims because, according to the label, the product contains less than the required 20 percent RDI or DRV per RACC of the nutrient for which the claim is made. Specifically, your Pure Aloe product label and webpage bear the claim "Excellent sources of ... Fiber ...." The Nutrition Facts panel declares that a 4 fl oz serving of the product contains 8% of the Daily Value for fiber. The RACC for fruit juices is 240 mL, or 8 fl oz; therefore, this product contains only 16% of the Daily Value for fiber per RACC.
 

Nutrient content claims using the term "antioxidant" must also comply with the requirements listed in 21 CFR 101.54(g). These requirements state, in part, that for a product to bear such a claim, an RDI must have been established for each of the nutrients that are the subject of the claim [21 CFR 101.54(g)(1)], and these nutrients must have recognized antioxidant activity [21 CFR 101.54(g)(2)]. The level of each nutrient that is the subject of the claim must also be sufficient to qualify for the claim under 21 CFR 101.54(b), (c), or (e) [21 CFR 101.54(g)(3)]. Such a claim must also include the names of the nutrients that are the subject of the claim as part of the claim or, alternatively, the term "antioxidant" or "antioxidants" may be linked by a symbol (e.g., an asterisk) that refers to the same symbol that appears elsewhere on the same panel of the product label, followed by the name or names of the nutrients with recognized antioxidant activity [21 CFR 101.54(g)(4)). The use of a nutrient content claim that uses the term "antioxidant" but does not comply with the requirements of 21 CFR 101.54(g) misbrands a product under 403(r)(1)(A) of the Act. Therefore, the claims "Super Anti-Oxidant" and "Tremendous Source of Anti-Oxidants" for your Pure Aloe product are unauthorized nutrient content claims because the source of the antioxidant is not identified with use of the term as required in 21 CFR 101.54(g)(4).
 

Your Tart Cherry product 'label bears the unauthorized nutrient content claims "Tremendous Source of Anti-Oxidants" and "Organic Grape Seed: Tremendous Anti-Oxidant Values." The terms "tremendous source" and "tremendous" characterize the level of antioxidant nutrients in the product and, therefore, these claims are nutrient content claims (see section 403(r)(1) of the Act and 21 CFR 101.13(b)). Even if we determined that the terms "tremendous source" and "tremendous" could be considered synonyms for a term defined by regulation (e.g., "good source" or "high"), nutrient content claims that use the term "antioxidant" must meet the requirements of 21 CFR 101.54(g). The above claims do not include the nutrients that are the subject of the claims or use a symbol to link the term "antioxidant" to those nutrients, as required by 21 CFR 101.54(g)(4). Thus, these unauthorized nutrient content claims cause your product to be misbranded under section 403(r)(2)(A)(i) of the Act.
 

Your Tart Cherry product label also bears the unauthorized nutrient content claims "Enriched with: Organic Rose Hips: Rich in Bio-Flavonoids for free radical protection" and "Enriched with ... Organic Grape Seed," and your Pure Pomegranate (organic) label bears the unauthorized nutrient content claim "Rich in polyphenols & flavonoids to combat free radical damage." The terms "enriched" and "rich in" are defined by regulation and may be used to describe the level of certain substances for which an RDI or Daily Reference Value (DRV) has been established (21 CFR 101.54(b) and (e). Therefore, because rose hips, grape seed, polyphenols, and flavonoids do not have an established RDI or DRV, these claims are unauthorized.
 

Other Food Labeling Violations

Your Fresh Pressed Blueberry Blend, Pure Pomegranate (organic), Pure Aloe, and Tart Cherry juice beverage products are further misbranded within the meaning of Section 403(q)(1) of the Act [21 U.S.C. 343(q)(1)] because the nutrition facts information is not in the proper format as defined in 21 CFR 101.9. Specifically, the Pure Aloe, Pure Pomegranate (organic), Tart Cherry, and Fresh Pressed Blueberry Blend product labels fail to properly declare the serving size as specified by 21 CFR 101.9(b) and 101.12(b). The serving size for a fruit juice product is based on the RACC, which is 240 mL, or 8 fl oz. However, the Pure Pomegranate (organic), Pure Aloe, and Fresh Pressed Blueberry product labels declare a serving size of 4 fl oz, and the Tart Cherry label declares a serving size of 6 fl oz.
 

Your Organic Pure Aloe juice beverage product is misbranded within the meaning of section 403(i)(2) of the Act [21 U.S.C. § 343(i)(2)] because the percentage of fruit juice is declared in the incorrect format. Specifically, 21 CFR 101.30(e)(1) requires that the percent juice statement appear near the top of the information panel with no other printed label information appearing above the statement except the brand name, product name, logo, or universal product code. Your product label includes the statement "Contains Pure Aloe Vera Fortified & Enriched" above your percent juice statement.
 

The above violations are not meant to be an all-encompassing list of deficiencies in your products and their labeling. It is your responsibility to ensure that products marketed by your firm comply with the Act and its implementing regulations. We urge you to review your websites, product labels, and other labeling or promotional materials for your products to ensure that the claims you make for your products do not cause them to violate the Act. You should take prompt action to correct these violations and prevent their future recurrence. Failure to correct these violations may result in regulatory actions without further notice, such as seizure and/or injunction [21 U.S.C. §§ 332 and 334].
 

We also have the following additional comments regarding your labels:
 

• Your Fresh Pressed Blueberry Blend product label does not comply with the requirements for declaring the statement of identity. Specifically, in a diluted multiple-juice blend or blend of single-strength juices where one or more, but not all, of the juices are named on the label other than in the ingredient statement, and where the named juice is not the predominant juice, the common or usual name for the product shall either indicate that the named juice is present as a flavor or flavoring (21 CFR 102.33(d)(1)) or include the amount of the named juice, declared in a 5-percent range (21 CFR 102.33(d)(2)). The named juice in this product is blueberry juice, and the ingredient statement indicates that blueberry juice is not the predominant juice because it is not listed first in the ingredient statement. However, the statement of identity does not indicate that blueberry juice is present as a flavor or flavoring (e.g., "Apple and Blueberry Juice Beverage") or include the amount of blueberry juice.
 

• Your Fresh Pressed Blueberry Blend, Pure Pomegranate (organic), Pure Aloe, and Tart Cherry product labels declare a percent Daily Value (% DV) for trans fat on the "Nutrition Facts" panel. A % DV for trans fat has not been established; consequently, it cannot be declared on the label.
 

• The Organic Pure Aloe product label fails to bear a common or usual name that accurately describes the basic nature of the product or its characterizing properties or ingredients [21 CFR 102.5]. Since the ingredient statement contains "organic lemon juice" and "organic lime juice," it appears to be a juice in a blend of two other fruit juices, and the common or usual name should signify that the product is a juice blend.
 

• The information panel of your Organic Tart Cherry product label bears a logo that separates the Nutrition Facts panel from the name and place of business of the firm. Under 21 CFR 101.2(e), all information required to appear on the information panel must appear in one place without other intervening material.
 

• Your Fresh Pressed Blueberry Blend label expresses the number calories from fat as 2. Under 21 CFR 101.9(c)(1)(ii), the number of calories from fat must be expressed to the nearest 5-calorie increment, but amounts less than 5 calories may be expressed as zero. Except as provided under 21 CFR 101.9(f), if calories from fat are not required and are not declared, the statement "Not a significant source of calories from fat" must be placed at the bottom of the table of nutrient values in the same type size [21 CFR 101.9(c)(1)(ii)].
 

• According to their labels, your Fresh Pressed Blueberry Blend, Tart Cherry, and Pure Pomegranate (organic) products contain 1, 4, and 3 mg of sodium, respectively, per serving. Under 21 CFR 101.9(c)(4), the number of milligrams of sodium in a serving must be expressed as zero when the serving contains less than 5 mg of sodium.
 

• According to their labels, your Fresh Pressed Blueberry Blend and Pure Pomegranate (organic) products contain 0.5 g of protein per serving. The number of grams of protein in a serving must be expressed to the nearest gram; however, if a serving contains less than 1 gram, the statement "Contains less than 1 gram" or "less than 1 gram" may be used as an alternative [21 CFR 101.9(c)(7)].
 

• Your Pure Pomegranate (organic) product declares that each serving contains 0.5 grams of dietary fiber. Under 21 101.9(c)(6)(i), the number of grams of total dietary fiber per serving must be expressed to the nearest gram, except that if a serving contains less than 1 gram, declaration of dietary fiber is not required or, alternatively, the statement "Contains less than 1 gram" or "less than 1 gram" may be used [21 CFR 101.9(c)(6)(i)].
 

• Your Pure Aloe label does not express total calories to the nearest 5-calorie increment up to and including 50 calories, as required by 21 CFR 101.9(c)(1)]. Your product declares Total Calories as 4.
 

• Your Fresh Pressed Blueberry Blend, Pure Pomegranate (organic), and Tart Cherry juice products do not express all of the percentages for vitamins and minerals to the nearest 2-percent increment up to and including the 10-percent level, as required by 21 CFR 101.9(c)(8)(iii).
 

• Your Pure Aloe juice label does not list Vitamin A, calcium, and iron as required by 21 CFR 101.9(c)(8)(ii).
 

Please respond to this Warning Letter within fifteen (15) days from receipt with the actions you plan to take in response to this letter, including an explanation of each step being taken to correct the current violations and prevent similar violations. Include any documentation necessary to show that correction has been achieved. If you cannot complete the corrective actions within fifteen working days, state the reason for the delay and the time within which you will complete the correction.
 

You should direct your written reply to the Food and Drug Administration, Attention: Carla A. Norris, Compliance Officer, Maitland District Office, 555 Winderley Place, Suite 200, Maitland, Florida, 32751. If you have questions regarding any issues in this letter, please contact Carla Norris at (407) 475-4730.
 

Sincerely,
/S/
Emma R. Singleton
Florida District Director

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Tuesday, July 6, 2010

Western Milling Company 7/6/10

 

Department of Health and Human Services logoDepartment of Health and Human Services

Public Health Service
Food and Drug Administration
 Los Angeles District
Pacific Region
19701 Fairchild
Irvine, CA 92612-2506
Telephone: 949-608-2900
FAX: 949-608-4415 

WARNING LETTER


CERTIFIED MAIL
RETURN RECEIPT REQUESTED


July 6, 2010

W/L 28-10


Mr. Kevin H. Kruse, President
O.H. Kruse Grain & Milling Company / Western Milling Company
31120 Nutmeg Road
Goshen, California 93227


Dear Mr. Kruse:


A comprehensive inspection / for-cause investigation of your non-FDA licensed feed manufacturing facility called Western Milling Company, located at 310 South 24th Avenue in Phoenix, Arizona, was conducted by an Investigator from the U.S. Food and Drug Administration (FDA) between March 18 and March 31 of 2010. The inspection occurred as part of the investigation of a complaint made by a local dairy farm. During this inspection, significant deviations from the Current Good Manufacturing Practice (CGMP) regulations for medicated feeds, Title 21 Code of Federal Regulations, Part 225 (21 C.F.R. 225), were observed. Such deviations caused the animal feed being manufactured at this facility to be adulterated within the meaning of section 501(a)(2)(B) of the Federal Food, Drug, and Cosmetic Act (the Act), 21 U.S.C. § 351(a)(2)(B). In addition, several labeling deviations were observed that cause certain animal feed products manufactured by your firm to be misbranded foods under section 403(a)(1) of the Act, 21 U.S.C. § 342(a)(1).


The U. S. Food and Drug Administration's inspection found that your firm failed to implement adequate safeguards to prevent unsafe contamination in the production of medicated and nonmedicated feeds, per Title 21 C.F.R. 225.165. For example our written cleanout procedure directs mill employees to use (b)(4) as a flush following the manufacture of a medicated feed. The written cleanout procedure mentions "sequencing" but does not explain what sequencing is and does not contain a written sequencing plan. We do not believe this is a sufficient amount of direction to be effective.


We also found that not all deliveries of medicated animal feeds are adequately labeled to assure that the feed can be properly used by the consignee, 21 C.F.R. 225.180. Specifically, we found a number of customer-formula medicated feeds whose label did not contain the directions-for-use or other information relative to the medication that is required by the drug approval regulations.

For example, one product we looked at, a dairy feed containing (b)(4) which was manufactured on (b)(4) had a delivery invoice and a "LOAD IT SHEET" accompanying the shipment. However, neither document contained all of the required drug information, including directions-for-use, as required by 21 C.F.R 558.355.

The above is not intended as an all-inclusive list of violations. As an animal feed manufacturer of medicated and non-medicated feeds, you are responsible for ensuring that your overall operation and the products you manufacture and distribute are in compliance with the Act and its implementing regulations.

The specific violations noted in this letter and in the Inspectional Observations form (the FDA Form 483), issued at the close-out of the inspection, may be symptomatic of serious problems in your firm's manufacturing and quality assurance systems. You should investigate and determine the cause of the violations, take prompt actions to connect the violations and prevent their recurrence, and to bring your products into compliance. Failure to achieve prompt corrective action may result in regulatory action, without further notice, such as seizure and/or injunction.


We are in receipt of your letter responding to the FDA Form 483 (dated (b)(4)), signed (b)(6) by Included was a copy of the invoice from the scale service company showing that the scales have been serviced and certified. Also included was a copy of a label for a customer-formula medicated feed that contains (b)(4) and is labeled for dairy cows. The label information regarding (b)(4) is incorrect and still needs some additional work.


Although it appears from the response that you are working toward correcting the deviations noted at your facility, you must adequately implement and maintain each corrective action to ensure its effectiveness.


You should notify this office within fifteen (15) business days of receiving this letter of the steps you have taken to achieve and maintain compliance with the law. Your response should include an explanation of each step being taken to correct the violations noted in this letter. If corrective action cannot be completed within 15 business days, state the reason for the delay and the date by which the corrections will be completed. Include copies of any available documentation demonstrating that corrections have been made.

Please send your response to:


Blake Bevill
Director of Compliance Branch
U.S. Food & Drug Administration
19701 Fairchild
Irvine, California 92612-2506

Sincerely,
/S/
Director
Los Angeles District Office

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