Revisions to Labeling Requirements for Blood and Blood Components, Including Source Plasma, 7-18 [2011-33554]
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Federal Register / Vol. 77, No. 1 / Tuesday, January 3, 2012 / Rules and Regulations
subject to the annual revision of FAA
Order 7400.9 and publication of
conforming amendments.
FOR FURTHER INFORMATION CONTACT:
Jeanette Roller, Federal Aviation
Administration, Operations Support
Group, Western Service Center, 1601
Lind Avenue SW., Renton, WA 98057;
telephone (425) 203–4541.
SUPPLEMENTARY INFORMATION:
History
On August 31, 2011, the FAA
published in the Federal Register a
notice of proposed rulemaking (NPRM)
to amend controlled airspace at
Kwigillingok, AK (76 FR 54151).
Interested parties were invited to
participate in this rulemaking effort by
submitting written comments on the
proposal to the FAA. No comments
were received.
Class E airspace designations are
published in paragraph 6005 of FAA
Order 7400.9V dated August 9, 2011,
and effective September 15, 2011, which
is incorporated by reference in 14 CFR
71.1. The Class E airspace designations
listed in this document will be
published subsequently in that Order.
Except for editorial changes, this rule is
the same as published in the NPRM.
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The Rule
This action amends Title 14 Code of
Federal Regulations (14 CFR) part 71 by
modifying Class E airspace extending
upward from 700 feet above the surface,
at Kwigillingok Airport, Kwigillingok,
AK, to accommodate IFR aircraft
executing the two revised standard
instrument approach procedures at the
airport. This action is necessary for the
safety and management of IFR
operations. The portion of the airspace
that lies further than 12 miles offshore
and overlaps Norton Sound Low will be
amended in a future rulemaking.
The FAA has determined this
regulation only involves an established
body of technical regulations for which
frequent and routine amendments are
necessary to keep them operationally
current. Therefore, this regulation: (1) Is
not a ‘‘significant regulatory action’’
under Executive Order 12866; (2) is not
a ‘‘significant rule’’ under DOT
Regulatory Policies and Procedures
(44 FR 11034; February 26, 1979); and
(3) does not warrant preparation of a
regulatory evaluation as the anticipated
impact is so minimal. Since this is a
routine matter that will only affect air
traffic procedures and air navigation, it
is certified this rule, when promulgated,
will not have a significant economic
impact on a substantial number of small
entities under the criteria of the
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Regulatory Flexibility Act. The FAA’s
authority to issue rules regarding
aviation safety is found in Title 49 of the
U.S. Code. Subtitle 1, section 106
discusses the authority of the FAA
Administrator. Subtitle VII, Aviation
Programs, describes in more detail the
scope of the agency’s authority. This
rulemaking is promulgated under the
authority described in subtitle VII, part
A, subpart I, section 40103. Under that
section, the FAA is charged with
prescribing regulations to assign the use
of airspace necessary to ensure the
safety of aircraft and the efficient use of
airspace. This regulation is within the
scope of that authority as it modifies
controlled airspace at Kwigillingok
Airport, Kwigillingok, AK.
List of Subjects in 14 CFR Part 71
Airspace, Incorporation by reference,
Navigation (air).
Adoption of the Amendment
PART 71—DESIGNATION OF CLASS A,
B, C, D, AND E AIRSPACE AREAS; AIR
TRAFFIC SERVICE ROUTES; AND
REPORTING POINTS
1. The authority citation for 14 CFR
part 71 continues to read as follows:
■
Authority: 49 U.S.C. 106(g), 40103, 40113,
40120; E.O. 10854, 24 FR 9565, 3 CFR, 1959–
1963 Comp., p. 389.
[Amended]
2. The incorporation by reference in
14 CFR 71.1 of the Federal Aviation
Administration Order 7400.9V, Airspace
Designations and Reporting Points,
dated August 9, 2011, and effective
September 15, 2011 is amended as
follows:
■
Paragraph 6005 Class E airspace areas
extending upward from 700 feet or more
above the surface of the earth.
*
*
*
AAL AK E5
*
*
Kwigillingok, AK [Modified]
Kwigillingok Airport, AK
(Lat. 59°32′35″ N., long. 163°10′07″ W.)
That airspace extending upward from 700
feet above the surface within a 6.5-mile
radius of Kwigillingok Airport, and that
airspace extending upward from 1,200 feet
above the surface within a 74-mile radius of
Kwigillingok Airport, excluding that area
outside 12 miles from the shoreline that
overlies Norton Sound Low.
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Issued in Seattle, Washington, on
December 21, 2011.
William Buck,
Acting Manager, Operations Support Group,
Western Service Center.
[FR Doc. 2011–33566 Filed 12–30–11; 8:45 am]
BILLING CODE 4910–13–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Food and Drug Administration
21 CFR Parts 606, 610, and 640
[Docket No. FDA–2003–N–0097] (Formerly
2003N–0211)
Revisions to Labeling Requirements
for Blood and Blood Components,
Including Source Plasma
AGENCY:
Food and Drug Administration,
HHS.
ACTION:
Final rule.
The Food and Drug
Administration (FDA) is revising the
labeling requirements for blood and
blood components intended for use in
transfusion or for further manufacture
by combining, simplifying, and
updating specific regulations applicable
to labeling and circulars of information.
These requirements will facilitate the
use of a labeling system using machinereadable information that would be
acceptable as a replacement for the
‘‘ABC Codabar’’ system for the labeling
of blood and blood components. FDA is
taking this action as a part of its efforts
to comprehensively review and, as
necessary, revise its regulations,
policies, guidances, and procedures
related to the regulation of blood and
blood components. This final rule is
intended to help ensure the continued
safety of the blood supply and facilitate
consistency in labeling.
DATES: This rule is effective July 2,
2012.
FOR FURTHER INFORMATION CONTACT:
Benjamin Chacko, Center for Biologics
Evaluation and Research (HFM–17),
Food and Drug Administration, 1401
Rockville Pike, Suite 200N, Rockville,
MD 20852–1448, (301) 827–6210.
SUPPLEMENTARY INFORMATION:
SUMMARY:
In consideration of the foregoing, the
Federal Aviation Administration
amends 14 CFR part 71 as follows:
§ 71.1
7
I. Introduction
A. Background
This rule represents FDA’s efforts to
revise the regulations for blood and
blood components. The rule
consolidates most labeling requirements
for blood and blood components,
including Source Plasma, into one
section of the Code of Federal
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Regulations (CFR). The rule also
updates the regulations applicable to
circulars of information.
In the Federal Register of July 30,
2003 (68 FR 44678), FDA published a
proposed rule that proposed revisions to
update requirements for storage and
shipment of blood and blood
components. FDA received numerous
comments in response to these
proposals, many of which opposed the
changes primarily due to economic
concerns. FDA has reviewed these
comments and appreciates the concerns
raised, and is currently reevaluating
these proposals. (See discussion in
section II.B of this document.)
B. Development of the International
Society of Blood Transfusion Code
(ISBT) 128
In the Federal Register of August 30,
1985 (50 FR 35472), we published a
notice of availability entitled ‘‘Guideline
for the Uniform Labeling of Blood and
Blood Components,’’ which described
the uniform container label for blood
and blood components and
recommended labels that incorporated
barcode symbology known as ‘‘ABC
Codabar.’’
Because the ‘‘ABC Codabar’’ system
was becoming outdated, we asked the
Blood Products Advisory Committee
(BPAC), on March 23, 1995, whether
there was persuasive evidence for us to
allow conversion from ‘‘ABC Codabar’’
to International Society of Blood
Transfusion Code 128 (ISBT 128),
according to the International Council
for Commonality in Blood Banking
Automation (ICCBBA) proposed
timetable. The BPAC voted in favor of
accepting the proposed timetable by
ICCBBA. The BPAC meeting transcript
also indicates the Department of
Defense’s and the blood industry’s,
including America’s Blood Centers’ and
AABB’s (formerly known as American
Association of Blood Banks), support of
the move to ISBT 128 for blood and
blood components for transfusion.
After the BPAC meeting, ICCBBA
developed and submitted to FDA a draft
standard entitled ‘‘United States
Industry Consensus Standard for the
Uniform Labeling of Blood and Blood
Components Using ISBT 128,’’ Version
1.2.0 (draft standard), recommending
that ISBT 128 replace ‘‘ABC Codabar.’’
In the Federal Register of November 27,
1998 (63 FR 65600), we announced the
availability of the draft standard and
requested public comment on both the
use of ISBT 128 and timeframes for
implementation.
The ICCBBA revised the draft
standard in response to public comment
and submitted to FDA a revised draft
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standard entitled ‘‘United States
Industry Consensus Standard for the
Uniform Labeling of Blood and Blood
Components Using ISBT 128,’’ Version
1.2.0, dated November 1999 (the
Version 1.2.0 Standard). We reviewed
the new draft standard, the comments
received in response to the Federal
Register notice of November 27, 1998,
and the Version 1.2.0 Standard, and
concluded that conformance to the
Version 1.2.0 Standard, prepared and
reviewed by ICCBBA, would help
facilitate the use of a uniform container
label for blood and blood components.
Thus, in the Federal Register of June 6,
2000 (65 FR 35944), we announced the
availability of a final guidance entitled
‘‘Guidance for Industry: Recognition
and Use of a Standard for the Uniform
Labeling of Blood and Blood
Components’’ dated June 2000, which
recognized as acceptable, except where
inconsistent with the regulations, use of
the Version 1.2.0 Standard and the
implementation of the ISBT 128
uniform labeling system. This guidance
identified two inconsistencies between
the Version 1.2.0 Standard and the
requirements in part 606 (21 CFR part
606) at § 606.121; the first inconsistency
concerned the requirement that on
container labels for Whole Blood the
name of the applicable anticoagulant
must immediately precede the proper
name of the product (§ 606.121(e)(1)(ii));
and the second inconsistency concerned
the requirement that the proper name of
the product and any appropriate
modifiers must be printed in solid red
(§ 606.121(d)(2)).
In the Federal Register of August 19,
1999 (64 FR 45366), we published a
direct final rule entitled ‘‘Revisions to
the Requirements Applicable to Blood,
Blood Components, and Source
Plasma,’’ which amended
§ 606.121(d)(2) by adding ‘‘or in solid
black,’’ thereby eliminating the
inconsistency between the Version 1.2.0
Standard and § 606.121(d)(2), which
had previously required that any
modifier be printed in solid red.
In the ‘‘Guidance for Industry:
Recognition and Use of a Standard for
Uniform Blood and Blood Component
Container Labels’’ dated September
2006 (https://www.fda.gov/downloads/
BiologicsBloodVaccines/Guidance
ComplianceRegulatoryInformation/
Guidances/Blood/ucm079004.pdf), we
recognized as acceptable, except where
inconsistent with the regulations, use of
the ‘‘United States Industry Consensus
Standard for the Uniform Labeling of
Blood and Blood Components Using
ISBT 128’’ version 2.0.0, dated
November 2005 (the Version 2.0.0
Standard). In the guidance, we noted
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that the Version 2.0.0 Standard revised
the Version 1.2.0 Standard and that
there remained an inconsistency
between the Version 1.2.0 Standard, the
Version 2.0.0 Standard and the
requirements at § 606.121(e)(1)(ii). Since
that guidance was issued, we have
identified another inconsistency
between the requirements under
§ 606.121(c)(2) and the Version 2.0.0
Standard regarding the requirement to
include the FDA assigned registration
number on blood and blood component
labels. This final rulemaking addresses
these inconsistencies by eliminating the
existing inconsistencies between the
Version 2.0.0 Standard and the
requirements at § 606.121(c)(2) and
(e)(1)(ii).
(FDA has verified the Web site
addresses in this document, but FDA is
not responsible for subsequent changes
after this document publishes in the
Federal Register.)
C. The Proposed Rule
In the Federal Register of July 30,
2003 (68 FR 44678), we published a
proposed rule entitled ‘‘Revisions to
Labeling and Storage Requirements for
Blood and Blood Components,
Including Source Plasma’’ (the proposed
rule), to combine, simplify and update
specific regulations applicable to
container labeling and instruction
circulars for all human blood and blood
components, including Source Plasma.
We also proposed to revise the shipping
and storage requirements for certain
human blood and blood components.
Furthermore, we proposed the use of a
labeling system using machine-readable
information that would be acceptable as
a replacement for the ‘‘ABC Codabar’’
system for labeling blood and blood
components, and stated that we would
also address the existing inconsistencies
between the Version 1.2.0 Standard, and
the existing regulations as described in
section I.B of this document. We also
intended to provide more flexibility for
inventory management, and to update
current requirements designed to ensure
potency of the blood components over
time by revising the current storage and
shipping temperature requirements for
frozen noncellular blood components,
both for transfusion and for further
manufacture (e.g., Cryoprecipitated
Antihemophilic Factor, Fresh Frozen
Plasma, and Source Plasma).
We note that the proposed rulemaking
inadvertently included proposed
changes to § 606.121(c)(13) (68 FR
44678 at 44686), which were
inconsistent with a previously proposed
amendment to § 606.121(c)(13) in an
earlier, related proposed rule entitled
‘‘Bar Code Label Requirement for
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Human Drug Products and Blood’’ that
published in the Federal Register of
March 14, 2003 (68 FR 12499). To
eliminate any confusion, we published
a correction to the proposed rule in the
Federal Register of October 27, 2003 (68
FR 61172), and published the related,
final rule entitled ‘‘Bar Code Label
Requirements for Human Drug Products
and Blood’’ in the Federal Register of
February 26, 2004 (69 FR 9120). We also
note that the proposed rulemaking
inadvertently omitted the requirement
in current 21 CFR 640.70(a)(7) that
requires that for Source Plasma, in the
case of immunized donors, the label
must state the immunizing antigen. In
this final rule, we have corrected this
omission and have placed this
requirement in redesignated
§ 606.121(e)(5)(vi).
Regarding the term ‘‘communicable
disease testing,’’ used in this final rule,
we noted in the proposed rule (68 FR
44678 at 44684) that the terms
‘‘infectious agent testing’’ and
‘‘communicable disease testing’’ (used
interchangeably in the proposed rule
and in guidance documents) refer to the
same testing performed in accordance
with § 610.40 (21 CFR 610.40). We also
noted that the term ‘‘infectious agent’’ is
used rather than ‘‘communicable
disease agent’’ for consistency with
labeling approved by the Director,
Center for Biologics and Evaluation
Research (CBER), for the Version 1.2.0
Standard and the ‘‘ABC Codabar’’
System. In this final rule, as well as in
the Version 2.0.0 Standard, the terms
‘‘infectious agent testing’’ and
‘‘communicable disease testing’’
continue to be used interchangeably and
refer to the same testing performed in
accordance with § 610.40.
II. Revisions to the Proposed Rule
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A. Requirements Finalized in This Rule
This rule:
• Finalizes, in part, the proposed
requirements for labeling for blood and
blood components intended for use in
transfusion or further manufacture by
all blood establishments, and specific
regulations applicable to container
labeling and circulars of information;
• Eliminates the two remaining
inconsistencies between the Version
2.0.0 Standard and the regulations,
described in section I.B of this
document;
• Facilitates the use of a labeling
system using machine-readable
information that would be acceptable as
a system for labeling blood and blood
components, and the use of new
labeling systems that may be developed
in the future;
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• Consolidates regulations applicable
to labeling standards so that most
labeling requirements for all blood and
blood components, including Source
Plasma, found previously in §§ 606.121
and 640.70, can now be found in
§ 606.121;
• Updates some of the consolidated
regulations;
• Replaces ‘‘shall’’ with ‘‘must’’ in all
places wherever it appears in the
regulations;
• Retitles part 606, subpart G; and
• Makes other, necessary conforming
changes, and technical amendments.
B. Requirements Not Finalized in This
Rule
At this time, we are not finalizing the
proposed requirements for storage and
shipping temperatures of certain human
blood and blood components, including
Source Plasma, because we are
continuing to reevaluate these
proposals, taking into account the
adverse comments received. Under the
proposed rule, we proposed revisions to
the labeling requirements regarding
storage and shipping temperatures for
frozen noncellular blood components in
current part 640 (21 CFR part 640) at
§ 640.70(a)(3) and (b). We also proposed
revisions to storage and shipping
temperatures in current §§ 600.15 (21
CFR 600.15), 610.53, 640.34, 640.54,
640.69, and 640.76 to help ensure the
potency of the frozen noncellular blood
components and for consistency
between the labeling regulations and the
regulations concerning shipping and
storage temperatures of frozen
noncellular blood components. By
updating the storage and shipping
temperature requirements and
addressing as many labeling changes as
possible at one time, we had believed
that the proposed rule would limit the
number of times establishments would
have to revise container labels.
However, we have concluded, based
on comments received, that we should
reevaluate the proposed revisions to the
requirements for storage and shipping
temperatures. For example, we received
comments from the plasma fractionation
industry stating that the proposed
freezing/storage temperature of ¥30 °C
was below the temperature that would
be acceptable to preserve product
activity, would be very costly to
implement, and would pose a safety
hazard to employees working in that
environment. In the Federal Register of
August 9, 2004 (69 FR 48250), we
announced a public workshop entitled
‘‘Development of Plasma Standards’’
that was held August 31 and September
1, 2004. The objective of the workshop
was to gather information on current
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9
industry practices that are in place for
the manufacture of plasma. We also
discussed this issue at a March 17, 2005,
BPAC meeting and at an April 2, 2009,
BPAC meeting.
FDA intends to consider revising
storage requirements in the future,
based on our review of scientific
literature, data from other regulatory
authorities and the plasma fractionation
industry, and input from BPAC. Based
on the information received, we intend
to develop standards for the
preparation, labeling, storage, and
shipping of frozen noncellular blood
components for transfusion and for
further manufacture.
C. Conforming and Clarifying Changes
This final rule removes § 640.70 from
the CFR, and accordingly, we have
made conforming changes to
§ 610.40(h)(2)(ii)(B) and § 640.74(b)(4)
both of which currently reference
§ 640.70. In § 610.40(h)(2)(ii)(B), we
have deleted the reference to § 640.70.
In § 640.74(b)(4), we have deleted the
reference to § 640.70(a) and replaced it
with § 606.121 and have deleted the
reference to § 640.70(a)(3) and replaced
it with § 606.121(e)(5)(ii).
We also made a conforming change to
§ 610.40(i) to cross-reference another
existing requirement for a serological
test for syphilis under § 640.65(b)(1).
We also made a conforming change to
§ 606.121(c)(13)(iii)(D) to cross-reference
other existing requirements under
§ 606.121(c)(9) and § 606.121(i)(5).
We are clarifying proposed
§ 606.121(i)(4) by removing the phrase
‘‘unless exempt under’’ to ‘‘except as
provided in.’’ This clarifying change
will not affect the substantive
requirements in this regulation.
Further, we made two clarifying
changes to § 606.122(f) by changing
‘‘statements’’ to ‘‘statement’’ and
replacing the period after ‘‘Warning’’
with a colon, so that the provision now
reads in its entirety, ‘‘The statement:
‘Warning: The risk of transmitting
infectious agents is present. Careful
donor selection and available laboratory
test do not eliminate the hazard.’’
D. Technical Amendment
We have made a technical
amendment to § 606.170 to clarify that
reports of the investigation of a fatality
must be submitted to CBER either by
mail, facsimile, or electronically
transmitted mail; and to provide mailing
address information for the Director,
Office of Compliance and Biologics
Quality, CBER.
Further, we have made a technical
amendment to § 606.121(e)(2)(i) to
require that with the exception of those
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products listed in § 606.121(e)(2), red
blood cell product labels must include
the type of additive solution with which
the product was prepared.
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III. Comments on the Proposed Rule
and FDA’s Responses
We received approximately 24
comments on the proposed rule. These
comments were received from blood
establishments, private and public
interest groups, and the general public.
All of the comments expressed opinions
on the proposed revisions to the storage
and shipping temperature requirements;
about 12 of the comments commented
on the proposed labeling requirements.
Because we are not finalizing the
proposed storage and shipping
temperature requirements at this time,
this document does not discuss those
issues. This document discusses
information relevant to and comments
concerning the proposed revisions to
the labeling requirements. To make it
easier to identify comments and our
responses, the word ‘‘Comment,’’ in
parentheses, will appear before the
description of comments, and the word
‘‘Response,’’ in parentheses, will appear
before our responses.
A. General
(Comment 1) Numerous comments
supported the proposed revisions to
consolidate, simplify and update the
regulations applicable to container
labeling and the instruction circular;
one comment stated that the changes
were ‘‘long overdue.’’ Several comments
applauded our efforts to develop a
proposed rule that will facilitate the
implementation of ‘‘machine-readable’’
bar code standards and strongly
endorsed the use of ISBT 128 as a
unifying bar code standard for blood
and blood components, which will
improve patient safety. In addition, one
of these comments noted that one bar
code standard would lower the
implementation costs related to the
standard and would allow for the
exchange of inventories so that the
needs of patients everywhere could be
more easily met.
(Response) We appreciate these
supportive comments. We agree that
this rule facilitates the use of the ISBT
128 machine readable labeling system
for blood components by eliminating
FDA requirements that are inconsistent
with the use of the ISBT system. We
note that once this rule is in effect,
licensed establishments will no longer
need to request a variance from the
regulations to fully implement the ISBT
system—thus we anticipate that the new
rule will save both industry and FDA
resources. In addition, the rule updates
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current labeling requirements to ensure
appropriate and complete labeling of all
blood and blood components for
infectious disease test results, including
recovered plasma for further
manufacturing. In these ways, the rule
will support the safety of the nation’s
blood supply.
At the same time, we are preserving
for industry the option of using the
older labeling system, ‘‘ABC Codabar.’’
(Comment 2) One comment expressed
concern that consolidating the labeling
requirements for Source Plasma and
other blood components into the same
CFR section may make it more difficult
to identify the applicable labeling
requirements, and suggested as an
alternative that we consolidate
requirements into a single section with
a subsection dedicated to requirements
specific to Source Plasma. Another
comment noted that consolidating
requirements into one section has both
advantages and disadvantages. This
comment noted that the manufacture of
Source Plasma is significantly different
from the manufacture of blood
components for transfusion. The
comment also noted that other blood
products, which are markedly different
from blood components for transfusion,
have separate labeling requirements in
the CFR (e.g., Albumin (part 640,
subpart H), Plasma Protein Fraction
(part 640, subpart I), and Immune
Globulin (part 640, subpart J)). The
comment noted that for consistency, we
should maintain separate labeling
requirements for Source Plasma in part
640, subpart G, and instead revise
§ 640.70 to require labeling statements
based on communicable disease testing.
Two comments noted that a
requirement for all test results to be
recorded on the product label is not
consistent with current industry
practice for recovered plasma. See
response to comment 8 for further
information.
(Response) One purpose of the
proposed rule was to consolidate the
labeling regulations that apply to blood
and blood components in one place in
the CFR, including blood components
that are used for further manufacture.
Not all blood components that are used
for further manufacture currently have
additional standards in part 640, e.g.,
recovered plasma. In § 606.121, we have
consolidated the labeling requirements
for blood and blood components
intended for use in transfusion or
further manufacture. To clarify this
point, in § 606.121(a), we have deleted
the phrase ‘‘including Source Plasma’’
from the proposed language and added
instead ‘‘intended for use in transfusion
or further manufacture.’’ We have also
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revised § 606.121(c)(11) to require that if
the product is intended for further
manufacturing use, a statement listing
the results of all the tests for
communicable disease agents required
under § 610.40 for which the donation
has been tested and found negative must
be on the container label; except that the
container label for Source Plasma is not
required to list the negative results of
serological syphilis testing under
§ 610.40(i) and § 640.65(b).
In response to comments regarding
current industry practice for negative
labeling of recovered plasma for further
manufacture, we believe that it is
current industry practice to include the
communicable disease test results for
recovered plasma on the container label.
See the response to comment 8 for full
details.
(Comment 3) One comment requested
that in addition to the revisions in this
final rule, we make changes to further
streamline the labeling submission
process for on-demand ISBT 128 labels.
(Response) The comment is beyond
the scope of this final rule. However, we
will consider the comments on this
issue at a later date.
(Comment 4) One comment requested
more flexibility on tie-tags used for
autologous donations, suggesting that a
computer system-generated ABO blood
group and Rh type (ABO/Rh) label be
applied to the tie-tag as opposed to the
current practice of hand writing the
ABO/Rh result on the tag and on the
‘‘For Autologous Use’’ label. The
comment stated that this change would
eliminate the need for handwritten
information, thus reducing the
likelihood of human error, thereby
improving patient safety.
(Response) The comment regarding
the use of a computer system-generated
ABO/Rh label is beyond the scope of
this final rule. However, we note that in
the final rule published in the Federal
Register of February 26, 2004 (69 FR
9120), entitled ‘‘Bar Code Label
Requirements for Human Drug Products
and Biological Products,’’ we revised
§ 606.121(c)(13) to require that the ABO
blood group and Rh type of the donor
be present in machine-readable format
on the container label of all blood and
blood components, including
autologous units. This requirement is
consistent with ISBT 128 standards but
requires those manufacturers using
‘‘ABC Codabar’’ to affix an ABO/Rh bar
code label to the ‘‘For Autologous Use
Only’’ label on blood and blood
components bearing the autologous
label. In this final rule, we have
amended § 606.121(i)(5) to permit each
container label of blood and blood
components intended for autologous use
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and obtained from an unsuitable donor
or one who is reactive for evidence of
infection due to communicable disease
agents under § 610.40 to include the
ABO and Rh blood group and type.
However, such labeling is not required.
B. 21 CFR 606.121(b)
The proposed rule amended
§ 606.121(b) by adding the phrase ‘‘with
any appropriate modifiers and
attributes’’ to clarify that the label
provided by the collecting facility may
be altered under certain circumstances
and may be altered multiple times to
adequately identify the contents of a
container. Examples of appropriate
modifiers include ‘‘washed,’’ ‘‘frozen,’’
and ‘‘liquid.’’ Examples of appropriate
attributes include ‘‘irradiated’’ and
‘‘divided,’’ which would indicate a
process change. We have finalized these
requirements as proposed, including the
conforming amendments to
§§ 606.121(c)(1) and 606.121(d)(2). In
addition, we have added the clarifying
phrases ‘‘of the product’’ and
‘‘considered finished products’’ to
§ 606.121(b). In this section III.B, we
describe two examples of circumstances
where it is acceptable to alter the label
of blood components as finished
products after they have been prepared.
We note that it is appropriate to revise
the label each time, after the finished
product has been prepared.
In the preamble of the final rule
entitled ‘‘Current Good Manufacturing
Practice for Blood and Blood
Components; Uniform Blood Labeling’’
published in the Federal Register of
August 30, 1985 (50 FR 35458), we
responded to a comment (comment
number 2) that suggested that the only
instance in which labels are permitted
to be altered pursuant to § 606.121(b) is
when blood components are removed
from the product. In the response, we
noted, that there are certain cases when
no blood components are removed from
a unit, but the unit may nonetheless
require relabeling. Id. at 35459. For
example, such relabeling would be
appropriate when the product is further
processed by freezing, pooling, washing,
or irradiating, provided that the
establishments have a validated process
for this additional processing. The
original label would need to be
modified to include the additional
information and then reprinted and the
product relabeled, i.e., a new label
placed over the original label, to
accurately identify the product.
Another specific circumstance in
which the label of a blood product may
be altered under § 606.121(b) is when
the original label may need to be
recreated because the original bag is
destroyed while the product is further
processed by, for example, freezing,
pooling, washing, or irradiation. The
recreated label may be placed on the
new bag under applicable regulations
and the establishment’s standard
operating procedures.
C. 21 CFR 606.121(c)(2)
In the proposed rule, we proposed
amending § 606.121(c)(2) by replacing
‘‘registration number’’ with ‘‘unique
facility identifier.’’ Although, as we
discussed in the preamble to the
proposed rule (68 FR 44678 at 44683),
the FDA-assigned registration number is
acceptable as a ‘‘unique facility
identifier,’’ we wanted to be able to
provide for the use of other recognized
donation facility identification numbers,
such as the ISBT facility code (which
includes machine-readable
information). In addition, we proposed
removing the requirements of current
§ 640.70(a)(10) for ‘‘name, address, and
license number’’ on the Source Plasma
label because they are included in
proposed § 606.121(c)(2).
(Comment 5) One comment suggested
that this change imposes an additional
requirement on collectors of Source
Plasma operating multiple sites under a
single license.
(Response) FDA believes that the final
rule addresses this concern. In
consideration of this comment, we are
not requiring the container label for
blood components for further
manufacture to contain a unique facility
identifier at this time, because we
believe that the blood establishment’s
FDA approved product label contains
sufficient information to permit
identification of the collection facility.
Regarding Source Plasma, we have
learned that most collection facilities
include a unique facility identifier on
the container label. We agree that this is
useful information for identifying the
location where the Source Plasma was
collected.
The final rule requires a unique
facility identifier for the container label
of blood and blood components
intended for transfusion, to aid in
identifying the location where the blood
or blood component was collected or
processed. We note that the final rule
provides flexibility by using the term
‘‘unique facility identifier,’’ which may
be satisfied by using an establishment’s
registration number, the FDA
establishment identifier, an ISBT facility
code, or other designation that will
allow identification of the specific
location where the blood or blood
component was collected or processed.
For example, a blood establishment may
incorporate its unique facility identifier
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11
into the blood component donor, lot, or
pool number and use a validated
computer or other recordkeeping system
that will enable identification of the
facility that collected that blood or
blood component.
(Comment 6) One comment expressed
concern that their current approved
labels do not contain a unique site
specific identifier that was assigned by
FDA, other than the license number,
and that the effective date for the final
rule should provide adequate time for
implementation to allow for label
design, acquisition, procedural changes,
and depletion of available stock to
minimize transition costs.
(Response) Anticipating the need to
deplete existing label stock, the effective
date for the final rule (refer to section
VIII of the proposed rule) (68 FR 44678
at 44685) provides reasonable time for
use of the existing label stock. The final
rule becomes effective 180 days after the
date of publication in the Federal
Register.
D. 21 CFR 606.121(c)(10)
The proposed rule combined current
§ 606.121(c)(11) and part of current
§ 640.70(a)(2) and redesignated the
combined regulations as proposed
§ 606.121(c)(10). In addition, FDA
proposed to revise § 606.121(c)(10) by
adding a phrase to the first sentence to
clarify that blood and blood components
intended for further manufacture are
subject to these requirements.
Furthermore, FDA proposed to revise
§ 606.121(c)(10) by adding an alternative
warning statement and provided for the
use of ‘‘other cautionary statements as
approved by CBER.’’ FDA now is
finalizing the above amendments as
proposed (including deleting current
§ 606.121(e)(5)(ii)), because it is now
redundant in light of new
§ 606.121(c)(10)).
(Comment 7) Two comments
suggested that it is difficult to select the
proper cautionary statement to use
because information regarding
cautionary statements can be found in
other sections of the CFR, as well as in
certain FDA guidance documents.
(Response) We acknowledge that the
circumstances surrounding which
cautionary statement to use may vary.
We believe that the consolidation of the
labeling requirements in this
rulemaking for blood and blood
components for further manufacture,
including Source Plasma, should
enhance industry’s ability to select the
appropriate cautionary language. We
also note that reference 1 and reference
2 to this rulemaking provide general
guidelines about the uniform labeling of
blood and blood components. Further,
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we suggest that the commenters may
want to pose any specific questions to
CBER to obtain further guidance.
E. 21 CFR 606.121(c)(11)
We had proposed to redesignate and
combine current §§ 640.70(a)(8) and
(a)(11) as § 606.121(c)(11) and to revise
redesignated § 606.121(c)(11) to require
labeling statements indicating the
results of communicable disease tests
performed. The proposed change
provided that the labeling requirements
apply to all blood and blood
components for further manufacture,
including Source Plasma, and would
require establishments to label products
for further manufacture with the results
of communicable disease testing for
which the donation has been tested and
found negative.
(Comment 8) Some comments
expressed concern regarding the
resulting burdens from consolidating
previously referenced requirements into
§ 606.121. One comment requested that
§ 606.121(c)(11) be re-worded to
indicate that communicable disease
tests performed on a sample from the
donor of the unit are listed in the
current circular of information, thus
providing a much simpler and more
flexible method of meeting labeling
requirements without the expense of
constantly changing labels.
Additionally, the comment stated that
use of the circular of information would
also address concerns regarding the
shipment of positive units for further
manufacture, by labeling only the
positive units or alternatively
recommended continuing the current
method of noting ‘‘positives’’ on the
shipping form.
In addition, as discussed previously,
regarding recovered plasma, two
comments stated that a requirement for
all test results to be recorded on the
product label is not consistent with
current industry practice. The
comments indicated that to require
constant updating of labels to report all
negative test results is
counterproductive to the positive
labeling aspects of the proposed rule,
and requested that this requirement be
deleted from the final rule.
(Response) FDA disagrees with the
comments related to the use of the
circular of information to list
communicable disease test results. We
believe that it is not appropriate to reword proposed § 606.121(c)(11) to
require that information on
communicable disease testing
performed on components intended for
further manufacture be included in the
circular of information because the
circular of information applies only to
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transfusable products and not to
products intended for further
manufacture.
We note that we have periodically
addressed the uniformity of labeling.
For example, we announced the
availability of the final guideline
entitled ‘‘Guideline for Uniform
Labeling of Blood and Blood
Components’’ dated August 1985, which
described acceptable criteria for labels
consistent with current good
manufacturing practice regulations for
blood and blood components (part 606)
(https://www.fda.gov/downloads/
BiologicsBloodVaccines/Guidance
ComplianceRegulatoryInformation/
Guidances/Blood/UCM080974.pdf ). The
guideline included illustrated labels for
certain blood components used for
further manufacture (e.g., Source
Plasma, recovered plasma, and Source
Leukocytes), that had been reviewed
and approved by FDA. We also issued
‘‘Guidance for Industry: Recognition
and Use of a Standard for Uniform
Blood and Blood Component Container
Labels’’ dated September 2006, which
recognizes the ‘‘United States Industry
Consensus Standard for the Uniform
Labeling of Blood and Blood
Components Using ISBT 128,’’ dated
November 2005, as an acceptable
standard for blood and blood
component container labels, except
where inconsistent with the regulations.
(https://www.fda.gov/downloads/
BiologicsBloodVaccines/Guidance
ComplianceRegulatoryInformation/
Guidances/Blood/UCM079159.pdf ). As
discussed in section I.B of this
document, we further note that this final
rulemaking addresses the
inconsistencies that existed.
FDA also disagrees with the
comments concerning the labeling of
recovered plasma because we believe
they are incorrect. We believe it is the
usual and customary practice of the
blood industry to label the container
label of blood and blood components for
further manufacture with the negative
communicable disease test results of all
the tests for communicable disease
agents required under § 610.40, except
for Source Plasma with respect to
serological syphilis testing. We are
therefore finalizing the requirement in
this rulemaking that the label of blood
and blood components for further
manufacture must include a statement
listing the results of all the tests for
communicable disease agents required
under § 610.40 for which the donation
has been tested and found negative
except that the label for Source Plasma
is not required to list the negative
results of serological syphilis testing
under §§ 610.40(i) and 640.65(b).
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(Comment 9) One comment noted that
consistent with §§ 610.40(i) and
640.65(b)(1), Source Plasma is unique
because a serological test for syphilis is
performed at intervals of no more than
4 months, rather than at each individual
donation. The comment requested
clarification on whether syphilis is
considered a ‘‘communicable disease
agent’’ and if the labeling of serological
syphilis testing results is required on
units of Source Plasma. This comment
also expressed the concern that
requiring syphilis test results on each
Source Plasma unit would be
burdensome for industry because it is
current industry practice to pre-label
Source Plasma with required
communicable disease testing results.
(Response) As noted previously in the
response to comment 8, we are not
finalizing § 606.121(c)(11) as proposed.
We will therefore answer this comment
in light of the revised provisions of
§ 606.121(c)(11). Syphilis is deemed to
be a communicable disease agent; the
testing requirements for which are
included in part 610, subpart E (Testing
Requirements for Communicable
Disease Agents), specifically § 610.40(i).
Section 610.40(i) incorporates the
requirement in § 640.65(b) to test a
Source Plasma donor using a serological
test for syphilis at the donor’s initial
examination and at least once every four
months thereafter. (More limited testing
for Source Plasma reflects the reduced
risk presented by syphilis infected
collections of Source Plasma. In an FDA
Compliance Policy Guide revised in
1995, FDA observed that ‘‘the diseasecausing spirochetes are destroyed
during the storage and/or fractionation
of the [source] plasma.’’) 1
Under § 606.121(c)(11) as finalized,
the label for blood and blood
components intended for further
manufacture must list the results of all
the tests for communicable disease
agents required under § 610.40 for
which the donation has been tested and
found negative; except that the
container label for Source Plasma is not
required to list the negative results of
serological syphilis testing under
§ 610.40(i) and § 640.65(b). This is
because the regulations do not require
that each Source Plasma donation be
tested for syphilis. In the absence of test
results for each donation (e.g., in
connection with donations made in
month three) or where testing for
syphilis was performed and the test was
negative, the label is silent. When
testing is performed and is reactive for
1 https://www.fda.gov/ICECI/ComplianceManuals/
CompliancePolicyGuidanceManual/
ucm073876.htm.
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syphilis, the label for the unit associated
with the positive test and the label for
the unit of any donation(s) made after
obtaining the test results must
appropriately disclose that the Source
Plasma tested reactive by a serologic test
for syphilis as described in
§ 606.121(e)(5)(iv).
More generally, concerning the prelabeling of Source Plasma, it is FDA’s
expectation that tests for required
infectious disease tests are completed
prior to shipment of the Source Plasma
for further manufacture to the
fractionator or for distribution.
However, we also recognize that in
certain circumstances, nucleic acid test
(NAT) testing of Source Plasma may
take an extended period to resolve
positive NAT pools to identify an
individual positive unit. Additionally,
we recognize the difficulty of placing a
‘‘label’’ on a frozen product. We note
that Source Plasma may be labeled and
then may be shipped for pre-release
storage at another facility while still
under the manufacturer’s control due to
the manufacturer’s storage limitations.
This raises the question of whether it is
acceptable for a manufacturer to prelabel (at the time of collection) Source
Plasma as ‘‘tested and found negative’’
while performing NAT testing and
shipping such products under
quarantine (i.e., while still under the
manufacturer’s control) and delaying
release and distribution until all the test
results are obtained.
Under the revised regulation, if the
product is intended for further
manufacturing use, a statement listing
the results of all the tests for
communicable disease agents required
under § 610.40 for which the donation
has been tested and found negative must
be listed on the container label; except
that the container label for Source
Plasma is not required to list the
negative results of serological syphilis
testing under § 610.40(i) and § 640.65(b).
In addition, blood and blood
components intended for further
manufacture must be labeled in
accordance with § 610.40, when the
donation has been tested and
demonstrates evidence of infection due
to a communicable disease agent(s).
Under § 606.121(c)(11) as finalized, it
is acceptable for Source Plasma
manufacturers to place the label
indicating negative communicable
disease test results on the product prior
to completion of communicable disease
testing (pre-label) as long as either (1)
The unit is shipped to a storage facility
and remains under quarantine control
by the collection establishment until all
testing is completed and accurately
reflected on the label or (2) the unit is
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not released and distributed into
interstate commerce until the results
from all communicable disease tests are
obtained and accurately reflected on the
label. Thus, the requirements under
§§ 606.121(c)(11) and 610.40 are not
fulfilled until the container label
accurately lists the results obtained from
all communicable disease testing
required under § 610.40. At that time,
the product is ready for distribution and
release into interstate commerce.
In the event that a shipped unit is prelabeled with a negative test result but is
later found positive upon completed
testing, that unit must be relabeled in
accordance with § 610.40, including
obliteration of the negative result.
F. 21 CFR 606.121(e)(2)(i) and 21 CFR
606.121(e)(5)(vi)
In finalizing this rulemaking, we have
amended § 606.121(e)(2)(i) to require
that with the exception of those
products listed in § 606.121(e)(2), red
blood cell product labels must include
the type of additive solution with which
the product was prepared as this
information is useful when making
determinations in connection with the
shelf life of the product. For example,
red cell additive solutions (e.g., AS–1,
AS–3, AS–5) provide nutrients to the
blood components which in turn allows
for an extended shelf life. We note that
the labeling of the container with the
additive solution is also industry
practice.
We proposed to redesignate current
§ 640.70(a)(7) as § 606.121(e)(5)(vi). We
also proposed to update redesignated
§ 640.70(a)(7) to broaden the labeling
requirements to include collections
from donors who are not immunized but
are in specific collection programs. The
proposal replaced the term ‘‘normal
donor’’ with the term ‘‘nonimmunized
donor.’’ After consideration, we have
determined that ‘‘nonimmunized
donor’’ is not a recognized term, and we
will continue to use the term ‘‘normal
donor.’’
G. 21 CFR 606.122
We proposed to amend § 606.122 by
revising the introductory paragraph and
paragraphs (e), (f), and (m). We received
comments only on the heading of this
regulation, ‘‘Instruction circular,’’ which
we did not propose to change, and
paragraphs (e) and (m).
1. Title for § 606.122
(Comment 10) A few comments
desired consistency between
§ 606.121(c)(8)(ii), which refers to the
‘‘Circular of Information,’’ and
§ 606.122, which refers to the
‘‘Instruction circular.’’ One comment
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13
suggested revising § 606.121(c)(8)(ii) to
use the same language in the AABB
‘‘Standards for Blood Banks and
Transfusion Services’’: ‘‘See Circular of
Information for the Use of Human Blood
and Blood Components.’’
(Response) We agree that there should
be consistency between
§§ 606.121(c)(8)(ii) and 606.122. We are
therefore revising the title of § 606.122
and the corresponding language in
§§ 606.122(k), (l), (m), and (n) by
replacing ‘‘Instruction circular’’ with
‘‘Circular of Information’’ to be
consistent with the wording required on
labels of blood and blood components
for transfusion, as illustrated in the
‘‘Guideline for the Uniform Labeling of
Blood and Blood Components’’ and the
‘‘United States Industry Consensus
Standard for the Uniform Labeling of
Blood and Blood Components Using
ISBT 128,’’ dated November 2005,
(https://www.fda.gov/downloads/
BiologicsBloodVaccines/Guidance
ComplianceRegulatoryInformation/
Guidances/Blood/UCM079159.pdf).
However, although it is a common
industry practice for blood
establishments to refer to the ‘‘Circular
of Information for the Use of Human
Blood and Blood Components,’’ we
decline to change § 606.121(c)(8)(ii) as
suggested because existing regulations
do not preclude blood establishments
from creating their own circulars of
information to address the labeling
standards required in § 606.122.
Moreover, § 606.121(c)(8)(ii) is
consistent with labeling approved by
the Director, CBER, i.e., ISBT 128 and
‘‘ABC Codabar.’’
2. 21 CFR 606.122(e) and 21 CFR
606.122(f)
We proposed that the instruction
circular contain statements regarding
the results of each infectious agent for
which the blood was tested, including
all FDA required tests, and found
negative. We have decided to clarify
that under § 606.122(e), a product
intended for transfusion must include a
statement that the product was prepared
from blood that was found negative
when tested for communicable disease
agents as required under § 610.40
(include each test that was performed).
We also proposed to amend § 606.122(f)
by updating the warning statement to
reflect the risk associated with the
communicable disease agents for which
testing is currently performed. We have
decided to keep the currently required
statement but note that we have made
two clarifying changes to this statement
by changing ‘‘statements’’ to
‘‘statement’’ and replacing the period
after ‘‘Warning’’ with a colon, so that
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the provision now reads in its entirety,
‘‘The statement: ‘Warning: The risk of
transmitting infectious agents is present.
Careful donor selection and available
laboratory tests do not eliminate the
hazard.’’’ to be consistent with the
warning statements reflected in the
current Circular of Information.
(Comment 11) One comment
supported the change if they correctly
interpreted ‘‘name each infectious
agent’’ as requiring a list of infectious
agents, and opined that it is not
necessary to ‘‘name’’ each type of test
that is performed for each infectious
agent. For example, according to the
comment, it is not necessary to list both
antibody tests and nucleic acid tests.
Another comment recommended that
either § 606.121(c)(11) or
§ 606.121(c)(8)(ii) should be revised to
require the label to bear a statement
‘‘See Circular of Information * * *
results of infectious agent testing.’’
(Response) We do not agree that the
infectious agent need only be listed
once on the labeling for both
transfusable products and products for
further manufacturing if the blood or
blood component was tested by
different tests for the same infectious
agent. We have revised § 606.122(e) to
clarify that the circular of information
must list the results of all donor
screening tests for communicable
disease agents required under § 610.40
for which the blood or blood component
was tested and found negative (e.g.,
negative for antibodies to HIV and Nonreactive for HIV–1 RNA). We interpret
‘‘negative’’ to include ‘‘Non-reactive.’’ In
response to the suggestion to revise
§ 606.121(c)(11), we refer to our
response to comment 8. As noted in that
response, we are not finalizing
§ 606.121(c)(11) as proposed. We also
believe that it is not practical to revise
§ 606.121(c)(8)(ii) to require a statement
of all negative test results on the
container label of blood and blood
components for transfusion, due to
space limitations on the container label.
We believe that the circular of
information is the best place to list this
type of information.
3. 21 CFR 606.122(m)(3)
The proposed rule proposed to clarify
that the instruction circular must
contain, when applicable, instructions
to begin administration of plasma
within ‘‘a specified time’’ after thawing.
(Comment 12) One comment
requested clarification of
§ 606.122(m)(3) and suggested that the
current statement in the Circular of
Information for the Use of Human Blood
and Blood Components, ‘‘Transfusion
should be completed within four hours
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and prior to component expiration,’’
could be used.
(Response) We do not want to
establish in regulation a specified time
to begin or complete the transfusion of
a plasma component. Instead, we
believe that it is appropriate to provide
industry with increased flexibility for
developing and specifying timeframes
for which thawed plasma components
can still be used for transfusions if
stored at appropriate temperatures per
industry standards. We are therefore
finalizing the amendment to
§ 606.122(m)(3) as proposed.
H. Concerns About Labeling for
Transfusable Products
(Comment 13) One comment asked if
manufacturers of licensed products will
have to resubmit labels for approval,
citing that such a requirement would
add to the cost of compliance and
impact the ability of some centers to
support out-of-state regions in need of
blood during FDA label review/approval
process time.
(Response) This rulemaking, in part,
updates existing regulations to be
consistent with current practice. Under
the final rule, licensed manufacturers
who have FDA approved container
labels that meet the requirements of the
final rule do not have to resubmit their
labels for approval. If a manufacturer
wishes to make labeling changes, a
supplement submission must be
submitted to FDA consistent with the
requirements under § 601.12(f)(1) (21
CFR 601.12(f)(1)).
(Comment 14) One comment
expressed concern that the proposed
revision to § 606.121(c)(2) will change
the commenter’s current FDA approved
labels and will cost blood
establishments approximately $40,000
annually in registration and licensing
fees if ISBT or a similar system is
utilized. A substantial additional cost
will be involved in the purchase of
printers, scanners, bar code readers,
validation, and training.
(Response) We are not requiring blood
establishments to utilize the ISBT
labeling system. Blood establishments
may continue to use the ‘‘ABC Codabar’’
system. Both of these systems are
acceptable labeling under the bar code
requirements.
IV. Legal Authority
FDA is issuing this rulemaking under
the biological products provisions and
the communicable diseases provisions
of the Public Health Service Act (PHS
Act) (42 U.S.C. 216, 262, 263, 263a, 264,
300aa–25), and the drugs, devices, and
general administrative provisions of the
Federal Food, Drug, and Cosmetic Act)
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(21 U.S.C. 321, 331, 351, 352, 353, 355,
360, 360c, 360d, 360h, 360j, 371, 372,
374 and 381). Under these provisions of
the PHS Act and the Federal Food,
Drug, and Cosmetic Act, we have the
authority to issue and enforce
regulations designed to ensure that
biological products are safe, pure,
potent, and properly labeled, and to
prevent the introduction, transmission,
and spread of communicable disease.
V. Analysis of Economic Impacts
FDA has examined the impacts of the
final rule under Executive Order 12866,
Executive Order 13563, the Regulatory
Flexibility Act (5 U.S.C. 601–612), and
the Unfunded Mandates Reform Act of
1995 (Pub. L. 104–4). Executive Orders
12866 and 13563 direct Agencies to
assess all costs and benefits of available
regulatory alternatives and, when
regulation is necessary, to select
regulatory approaches that maximize
net benefits (including potential
economic, environmental, public health
and safety, and other advantages;
distributive impacts; and equity). The
Agency believes that this final rule is
not a significant regulatory action under
Executive Order 12866.
The Regulatory Flexibility Act
requires Agencies to analyze regulatory
options that would minimize any
significant impact of a rule on small
entities. Because the requirements of the
final rule are either consistent with
industry practice or would be industry
practice absent existing prohibitions,
the Agency certifies that the final rule
will not have a significant economic
impact on a substantial number of small
entities.
Section 202(a) of the Unfunded
Mandates Reform Act of 1995 requires
that Agencies prepare a written
statement, which includes an
assessment of anticipated costs and
benefits, before proposing ‘‘any rule that
includes any Federal mandate that may
result in the expenditure by State, local,
and tribal governments, in the aggregate,
or by the private sector, of $100,000,000
or more (adjusted annually for inflation)
in any one year.’’ The current threshold
after adjustment for inflation is $136
million, using the most current (2010)
Implicit Price Deflator for the Gross
Domestic Product. FDA does not expect
this final rule to result in any 1-year
expenditure that would meet or exceed
this amount.
A purpose of the final rule is to
simplify and unify the existing labeling
standards. Labeling standards are
currently found in multiple sections of
the regulations and these amendments
would move these standards to one
section of the regulations. Through our
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revising, consolidating, and
redesignating these regulations, parties
wishing to understand the labeling
requirements will be able to refer to a
single source. This final rule also
includes provisions that add flexibility
to the regulations that should lower the
cost of compliance.
In the proposed rule, we asserted that
the new labeling requirements were
consistent with current industry
practice and did not impose an
additional burden. We received
comments stating that the proposed
labeling requirements for including all
communicable disease test results and a
unique facility identifier on the product
label did not conform to current
industry practice for certain blood and
blood components intended for further
manufacture. In the final rule, as a result
of these comments, we revised these
requirements. We have also amended
§ 606.121(e)(2)(i) to require that certain
red blood cell product labels must
include the type of additive solution
with which the product was prepared.
We believe that the labeling
requirements of the final rule conform
to current industry practice.
The final rule requires a change in the
circular of information to reflect current
testing practices. Existing labeling
regulations do not allow the circular to
reflect current required testing or to
adjust to future changes in required
testing or plasma thawing procedures.
We believe the circular of information
would already be in compliance with
the final rule amendments and reflect
current requirements and practices if
compliance were permitted by existing
regulations. As the circular is updated
regularly, we believe any required
changes can be made in the ordinary
revision cycle at a cost too small to
reliably quantify.
Overall, because the requirements of
this final rule are either industry
practice or would be industry practice
absent existing prohibitions, estimated
costs are negligible. We believe this
action to be beneficial as it increases
flexibility and lowers compliance costs.
Because we believe costs to any entity
will be too small to reliably quantify, we
certify that this final rule will not have
a significant impact on a substantial
number of small entities.
VI. Environmental Impact
The Agency has determined under 21
CFR 25.30(h) that this action is of a type
that does not individually or
cumulatively have a significant effect on
the human environment. Therefore,
neither an environmental assessment
nor an environmental impact statement
is required.
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VII. Federalism
FDA has analyzed this final rule in
accordance with the principles set forth
in Executive Order 13132. FDA has
determined that the final rule does not
contain policies that have substantial
direct effect on the States, on the
relationship between the National
Government and the States, or on the
distribution of power and
responsibilities among the various
levels of government. Accordingly, FDA
has concluded that the final rule does
not contain policies that have
federalism implications as defined in
the Executive order and, consequently,
a federalism summary impact statement
is not required.
VIII. The Paperwork Reduction Act of
1995
This final rule contains information
collection provisions that are subject to
review by the Office of Management and
Budget (OMB) under the Paperwork
Reduction Act of 1995 (44 U.S.C. 3501–
3520). The title, description, and
respondent description of the
information collection provisions are
shown in this section VIII with a
discussion of the information collection
burden.
Title: Revisions to Labeling
Requirements for Blood and Blood
Components, Including Source Plasma.
Description: FDA is consolidating the
regulations related to labeling blood and
blood components. Regulations for
labeling of all blood and blood
components would be consolidated in
§§ 606.121 (Container label) and
606.122 (Circular of information).
Description of Respondents:
Manufacturers of blood and blood
components, and blood derivatives.
Burden Estimate: Section
606.121(c)(11) requires that if the
product is intended for further
manufacturing use, a statement listing
the results of all the tests for
communicable disease agents required
under § 610.40 for which the donation
has been tested and found negative must
be on the container label; except that the
label for Source Plasma is not required
to list the negative results of serological
syphilis testing under §§ 610.40(i) and
640.65(b). The Agency believes that as
a part of industry’s usual and customary
labeling business practices, industry
currently labels blood and blood
components for further manufacture
with the results of required testing
found in § 610.40. In addition,
§ 606.121(e)(2)(i) requires that certain
red blood cell product labels must
include the type of additive solution
with which the product was prepared.
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15
The Agency believes that this labeling
requirement of the final rule also is part
of usual and customary industry
practice.
Because the Agency believes the rule
amendments and the information
collection provisions under
§ 606.121(c)(11) and (e)(2)(i) in the final
rule are part of usual and customary
business practice and do not create any
new burden for respondents, FDA is not
estimating the burden associated with
the information collection provisions in
this final rule.
The collection of information
requirements under §§ 606.121 and
606.122 are approved under OMB
control number 0910–0116; in § 640.70
have been approved under OMB control
number 0910–0338.
To comply with section 3506(c)(2)(A)
of the PRA (44 U.S.C. 3506(c)(2)(A)),
elsewhere in this Federal Register, FDA
is publishing a notice of the proposed
collection of information set forth in
this document. The collection of
information provisions of this final rule
have been submitted to OMB for review.
Prior to the effective date of this final
rule, FDA will publish a notice in the
Federal Register announcing OMB’s
decision to approve, modify, or
disapprove the new collection of
information provisions in this final rule.
An Agency may not conduct or sponsor,
and a person is not required to respond
to, a collection of information unless it
displays a currently valid OMB control
number.
IX. References
The following references have been
placed on display in the Division of
Dockets Management (HFA–305), Food
and Drug Administration, 5630 Fishers
Lane, Rm. 1061, Rockville, MD 20852,
and may be seen by interested persons
between 9 a.m. and 4 p.m., Monday
through Friday. FDA has verified the
Web site addresses in this document,
but FDA is not responsible for
subsequent changes after this document
publishes in the Federal Register.
1. ‘‘Guideline for the Uniform Labeling of
Blood and Blood Components,’’ August
1985, https://www.fda.gov/downloads/
BiologicsBloodVaccines/
GuidanceComplianceRegulatory
Information/Guidances/Blood/
UCM080974.pdf.
2. ‘‘United States Industry Consensus
Standard for the Uniform Labeling of
Blood and Blood Components Using
ISBT 128,’’ November 2005, https://
www.fda.gov/downloads/
BiologicsBloodVaccines/Guidance
ComplianceRegulatoryInformation/
Guidances/Blood/UCM079159.pdf.
3. ‘‘Guidance for Industry: Recognition and
Use of a Standard for Uniform Blood and
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Blood Component Container Labels,’’
September 2006, https://www.fda.gov/
downloads/BiologicsBloodVaccines/
GuidanceComplianceRegulatory
Information/Guidances/Blood/
ucm079004.pdf.
List of Subjects
21 CFR Part 606
Blood, Labeling, Laboratories,
Reporting and recordkeeping
requirements.
21 CFR Part 610
Biologics, Labeling, Reporting and
recordkeeping requirements.
21 CFR Part 640
Blood, Labeling, Reporting and
recordkeeping requirements.
Therefore, under the Federal Food,
Drug, and Cosmetic Act, and the Public
Health Service Act, and under authority
delegated to the Commissioner of Food
and Drugs, 21 CFR parts 606, 610, and
640 are amended as follows:
PART 606—CURRENT GOOD
MANUFACTURING PRACTICE FOR
BLOOD AND BLOOD COMPONENTS
1. The authority citation for 21 CFR
part 606 continues to read as follows:
■
Authority: 21 U.S.C. 321, 331, 351, 352,
355, 360, 360j, 371, 374; 42 U.S.C. 216, 262,
263a, 264.
2. Revise the heading for subpart G to
read as follows:
■
Subpart G—Additional Labeling
Standards for Blood and Blood
Components
3. Section 606.121 is revised to read
as follows:
■
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§ 606.121
Container label.
(a) The container label requirements
are designed to facilitate the use of a
uniform container label for blood and
blood components intended for use in
transfusion or further manufacture by
all blood establishments.
(b) The label provided by the
collecting facility and the initial
processing facility must not be removed,
altered, or obscured, except that the
label may be altered to indicate the
proper name of the product, with any
appropriate modifiers and attributes,
and other information required to
identify accurately the contents of a
container after blood components
considered finished products have been
prepared.
(c) The container label must include
the following information, as well as
other specialized information as
required in this section for specific
products:
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(1) The proper name of the product in
a prominent position, with any
appropriate modifiers and attributes.
(2) The name, address, unique facility
identifier, and, if a licensed product, the
license number of each manufacturer;
except the container label for blood and
blood components for further
manufacture is not required to include
a unique facility identifier.
(3) The donor or lot number relating
the unit to the donor. If pooled, all
donor numbers, all donation numbers,
or a pool number that is traceable to
each individual unit comprising the
pool.
(4)(i) The expiration date, including
the day, month, and year, and, if the
dating period for the product is 72 hours
or less, including any product prepared
in a system that might compromise
sterility, the hour of expiration.
(ii) If Source Plasma intended for
manufacturing into noninjectable
products is pooled, the expiration date
for the pool is determined from the
collection date of the oldest unit in the
pool, and the pooling records must
show the collection date for each unit in
the pool.
(5) For Whole Blood, Plasma,
Platelets, and partial units of Red Blood
Cells, the volume of the product,
accurate to within ±10 percent; or
optionally for Platelets, the volume or
volume range within reasonable limits.
(6) Where applicable, the name and
volume of source material.
(7) The recommended storage
temperature (in degrees Celsius).
(8) If the product is intended for
transfusion, the statements:
(i) ‘‘Rx only.’’
(ii) ‘‘See circular of information for
indications, contraindications, cautions,
and methods of infusion.’’
(iii) ‘‘Properly identify intended
recipient.’’
(iv) ‘‘This product may transmit
infectious agents.’’
(v) The appropriate donor
classification statement, i.e., ‘‘paid
donor’’ or ‘‘volunteer donor,’’ in no less
prominence than the proper name of the
product.
(A) A paid donor is a person who
receives monetary payment for a blood
donation.
(B) A volunteer donor is a person who
does not receive monetary payment for
a blood donation.
(C) Benefits, such as time off from
work, membership in blood assurance
programs, and cancellation of
nonreplacement fees that are not readily
convertible to cash, do not constitute
monetary payment within the meaning
of this paragraph.
(9) If the product is intended for
transfusion or as is otherwise
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appropriate, the ABO group and Rh type
of the donor must be designated
conspicuously. For Cryoprecipitated
Antihemophiliac Factor (AHF), the Rh
type may be omitted. The Rh type must
be designated as follows:
(i) If the test using Anti-D Blood
Grouping Reagent is positive, the
product must be labeled: ‘‘Rh positive.’’
(ii) If the test using Anti-D Blood
Grouping Reagent is negative, but the
test for weak D (formerly Du) is positive,
the product must be labeled: ‘‘Rh
positive.’’
(iii) If the test using Anti-D Blood
Grouping Reagent is negative and the
test for weak D (formerly Du) is negative,
the product must be labeled: ‘‘Rh
negative.’’
(10) If the product is not intended for
transfusion, a statement as applicable:
‘‘Caution: For Manufacturing Use
Only,’’ or ‘‘Caution: For Use in
Manufacturing Noninjectable Products
Only,’’ or other cautionary statement as
approved by the Director, Center for
Biologics Evaluation and Research
(CBER).
(11) If the product is intended for
further manufacturing use, a statement
listing the results of all the tests for
communicable disease agents required
under § 610.40 of this chapter for which
the donation has been tested and found
negative; except that the container label
for Source Plasma is not required to list
the negative results of serological
syphilis testing under §§ 610.40(i) and
640.65(b) of this chapter.
(12) The blood and blood components
must be labeled in accordance with
§ 610.40 of this chapter, when the
donation is tested and demonstrates
evidence of infection due to a
communicable disease agent(s).
(13) The container label of blood or
blood components intended for
transfusion must bear encoded
information in a format that is machinereadable and approved for use by the
Director, CBER.
(i) Who is subject to this machinereadable requirement? All blood
establishments that manufacture,
process, repack, or relabel blood or
blood components intended for
transfusion and regulated under the
Federal Food, Drug, and Cosmetic Act
or the Public Health Service Act.
(ii) What blood products are subject to
this machine-readable requirement? All
blood and blood components intended
for transfusion are subject to the
machine-readable information label
requirement in this section.
(iii) What information must be
machine-readable? Each label must
have machine-readable information that
contains, at a minimum:
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(A) A unique facility identifier;
(B) Lot number relating to the donor;
(C) Product code; and
(D) ABO and Rh of the donor, except
as described in paragraphs (c)(9) and
(i)(5) of this section.
(iv) How must the machine-readable
information appear? The machinereadable information must:
(A) Be unique to the blood or blood
component;
(B) Be surrounded by sufficient blank
space so that the machine-readable
information can be scanned correctly;
and
(C) Remain intact under normal
conditions of use.
(v) Where does the machine-readable
information go? The machine-readable
information must appear on the label of
any blood or blood component which is
or can be transfused to a patient or from
which the blood or blood component
can be taken and transfused to a patient.
(d) Unless otherwise approved by the
Director, CBER, the container label for
blood and blood components intended
for transfusion must be white and print
must be solid black, with the following
additional exceptions:
(1) The ABO and Rh blood groups
must be printed as follows:
(i) Rh positive: Use black print on
white background and use solid black or
other solid color for ABO.
(ii) Rh negative: Use white print on
black background for Rh and use black
outline on a white background for ABO.
(2) The proper name of the product,
with any appropriate modifiers and
attributes, the donor classification
statement, and the statement ‘‘properly
identify intended recipient’’ may be
printed in solid red or in solid black.
(3) The following color scheme may
be used for differentiating ABO Blood
groups:
Color of
label
Blood group
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O .....................................................
A .....................................................
B .....................................................
AB ...................................................
Blue
Yellow
Pink
White
(4) Special labels, such as those
described in paragraphs (h) and (i) of
this section, may be color-coded.
(e) Container label requirements for
particular products or groups of
products.
(1) Whole Blood labels must include:
(i) The name of the applicable
anticoagulant approved for use by the
Director, CBER.
(ii) The volume of anticoagulant.
(iii) If tests for unexpected antibodies
are positive, blood intended for
transfusion must be labeled: ‘‘Contains
(name of antibody).’’
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(2) Except for frozen, deglycerolized,
or washed Red Blood Cell products, Red
Blood Cell labels must include:
(i) The type of anticoagulant, and if
applicable, the volume of Whole Blood
and type of additive solution, with
which the product was prepared.
(ii) If tests for unexpected antibodies
are positive and the product is intended
for transfusion, the statement: ‘‘Contains
(name of antibody).’’
(3) If tests for unexpected antibodies
are positive, Plasma intended for
transfusion must be labeled: ‘‘Contains
(name of antibody).’’
(4) Recovered plasma labels must
include:
(i) In lieu of an expiration date, the
date of collection of the oldest material
in the container.
(ii) For recovered plasma not meeting
the requirements for manufacture into
licensable products, the statement: ‘‘Not
for Use in Products Subject to License
Under Section 351 of the Public Health
Service Act.’’
(iii) The type of anticoagulant with
which the product was prepared.
(5) Source Plasma labels must include
the following information:
(i) The cautionary statement, as
specified in paragraph (c)(10) of this
section, must follow the proper name
with any appropriate modifiers and
attributes and be of similar prominence
as the proper name.
(ii) The statement ‘‘Store at ¥20 °C or
colder,’’ provided, that where plasma is
intended for manufacturing into
noninjectable products, this statement
may be replaced by a statement of the
temperature appropriate for
manufacture of the final product to be
prepared from the plasma.
(iii) The total volume or weight of
plasma and total quantity and type of
anticoagulant used.
(iv) When plasma collected from a
donor is reactive for a serologic test for
syphilis, a statement that the plasma is
reactive and must be used only for the
manufacturing of positive control
reagents for the serologic test for
syphilis.
(v) Source Plasma diverted for Source
Plasma Salvaged must be relabeled
‘‘Source Plasma Salvaged’’ as prescribed
in § 640.76 of this chapter. Immediately
following the proper name of the
product, with any appropriate modifiers
and attributes, the labeling must
prominently state as applicable,
‘‘STORAGE TEMPERATURE
EXCEEDED ¥20 °C’’ or ‘‘SHIPPING
TEMPERATURE EXCEEDED ¥5 °C.’’
(vi) A statement as to whether the
plasma was collected from normal
donors, or from donors in specific
collection programs approved by the
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17
Director, CBER. In the case of specific
collection programs, the label must state
the defining characteristics of the
plasma. In the case of immunized
donors, the label must state the
immunizing antigen.
(f) Blood and blood components
determined to be unsuitable for
transfusion must be prominently labeled
‘‘NOT FOR TRANSFUSION,’’ and the
label must state the reason the unit is
considered unsuitable. The provision
does not apply to blood and blood
components intended solely for further
manufacture.
(g) [Reserved]
(h) The following additional
information must appear on the label for
blood and blood components shipped in
an emergency prior to completion of
required tests, in accordance with
§ 610.40(g) of this chapter:
(1) The statement: ‘‘FOR
EMERGENCY USE ONLY BY ll .’’
(2) Results of any tests prescribed
under §§ 610.40 and 640.5(a), (b), or (c)
of this chapter completed before
shipment.
(3) Indication of any tests prescribed
under §§ 610.40 and 640.5(a), (b), or (c)
of this chapter not completed before
shipment.
(i) The following additional
information must appear on the label for
blood and blood components intended
for autologous transfusion:
(1) Information adequately identifying
the patient, e.g., name, date of birth,
hospital, and identification number.
(2) Date of donation.
(3) The statement: ‘‘AUTOLOGOUS
DONOR.’’
(4) The ABO and Rh blood group and
type, except as provided in paragraph
(c)(9) of this section.
(5) Each container of blood and blood
component intended for autologous use
and obtained from a donor who fails to
meet any of the donor suitability
requirements under § 640.3 of this
chapter or who is reactive to or positive
for one or more tests for evidence of
infection due to communicable disease
agents under § 610.40 of this chapter
must be prominently and permanently
labeled ‘‘FOR AUTOLOGOUS USE
ONLY’’ and as otherwise required under
§ 610.40 of this chapter. Such units also
may have the ABO and Rh blood group
and type on the label.
(6) Units of blood and blood
components originally intended for
autologous use, except those labeled as
prescribed under paragraph (i)(5) of this
section, may be issued for allogeneic
transfusion provided the container label
complies with all applicable provisions
of paragraphs (b) through (e) of this
section. In such case, the special label
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in addition to the information required
by § 606.121 of this chapter, but
excluding § 606.121(e)(5)(ii) of this
chapter, the name of the manufacturer
of the final blood derivative product for
whom it was prepared.
*
*
*
*
*
be fatal, the Director, Office of
Compliance and Biologics Quality,
CBER, must be notified by telephone,
facsimile, express mail, or electronically
transmitted mail as soon as possible. A
written report of the investigation must
be submitted to the Director, Office of
Compliance and Biologics Quality,
CBER, by mail, facsimile, or
electronically transmitted mail (for
mailing addresses, see § 600.2 of this
chapter), within 7 days after the fatality
by the collecting facility in the event of
a donor reaction, or by the facility that
performed the compatibility tests in the
event of a transfusion reaction.
§ 606.122
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required under paragraphs (i)(1), (i)(2),
and (i)(3) of this section must be
removed or otherwise obscured.
(j) A tie-tag attached to the container
may be used for providing the
information required by paragraphs
(e)(1)(iii), (e)(2)(ii), and (e)(3), (h), or
(i)(1), (i)(2), and (i)(3) of this section.
■ 4. Section 606.122 is amended by:
■ a. Revising the section heading;
■ b. Revising the introductory text;
■ c. Revising paragraphs (e), (f), (m)(2),
(m)(3), and (m)(5); and
■ d. Revising the introductory text in
paragraphs (k), (l), (m), and (n).
The revisions read as follows:
PART 610—GENERAL BIOLOGICAL
PRODUCTS STANDARDS
Occupational Safety and Health
Administration
7. The authority citation for 21 CFR
part 610 continues to read as follows:
29 CFR Part 1915
Circular of information.
A circular of information must be
available for distribution if the product
is intended for transfusion. The circular
of information must provide adequate
directions for use, including the
following information:
*
*
*
*
*
(e) A statement that the product was
prepared from blood that was found
negative when tested for communicable
disease agents, as required under
§ 610.40 of this chapter (include each
test that was performed).
(f) The statement: ‘‘Warning: The risk
of transmitting infectious agents is
present. Careful donor selection and
available laboratory tests do not
eliminate the hazard.’’
*
*
*
*
*
(k) For Red Blood Cells, the circular
of information must contain:
*
*
*
*
*
(l) For Platelets, the circular of
information must contain:
*
*
*
*
*
(m) For Plasma, the circular of
information must contain:
(1) * * *
(2) Instructions to thaw the frozen
product at a temperature appropriate for
the product.
(3) When applicable, instructions to
begin administration of the product
within a specified time after thawing.
*
*
*
*
*
(5) A statement that this product has
the same risk of transmitting infectious
agents as Whole Blood; other plasma
volume expanders without this risk are
available for treating hypovolemia.
(n) For Cryoprecipitated AHF, the
circular of information must contain:
*
*
*
*
*
■ 6. Section 606.170 is amended by
revising paragraph (b) to read as follows:
§ 606.170
Adverse reaction file.
*
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Jkt 226001
Authority: 21 U.S.C. 321, 331, 351, 352,
353, 355, 360, 360c, 360d, 360h, 360i, 371,
372, 374, 381; 42 U.S.C. 216, 262, 263, 263a,
264.
8. Section 610.40 is amended by
revising paragraphs (h)(2)(ii)(B) and (i)
to read as follows:
■
§ 610.40
Test requirements.
*
*
*
*
*
(h) * * *
(2) * * *
(ii) * * *
(B) You must appropriately label such
blood or blood components as required
under § 606.121 of this chapter, and
with the ‘‘BIOHAZARD’’ legend;
*
*
*
*
*
(i) Syphilis testing. In addition to the
testing otherwise required under this
section, you must test by a serological
test for syphilis under §§ 640.5(a),
640.14, 640.23(a), 640.33(a), 640.53(a),
and 640.65(b)(1) and (b)(2) of this
chapter.
PART 640—ADDITIONAL STANDARDS
FOR HUMAN BLOOD AND BLOOD
PRODUCTS
9. The authority citation for 21 CFR
part 640 continues to read as follows:
■
Authority: 21 U.S.C. 321, 351, 352, 353,
355, 360, 371; 42 U.S.C. 216, 262, 263, 263a,
264.
§ 640.70
[Removed]
10. Section 640.70 is removed.
11. Section 640.74 is amended by
revising paragraph (b)(4) to read as
follows:
■
■
§ 640.74
Modification of Source Plasma.
*
*
*
*
*
(b) When a complication of blood
collection or transfusion is confirmed to
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■
*
*
*
*
(b) * * *
(4) The label affixed to each container
of Source Plasma Liquid shall contain,
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Dated: December 22, 2011.
Leslie Kux,
Acting Assistant Commissioner for Policy.
[FR Doc. 2011–33554 Filed 12–30–11; 8:45 am]
BILLING CODE 4160–01–P
DEPARTMENT OF LABOR
RIN 1218–AB50
General Working Conditions in
Shipyard Employment; Approval of
Information Collection Requirements
Occupational Safety and Health
Administration (OSHA), Labor.
ACTION: Final rule; notice of Office of
Management and Budget (OMB)
approval of collection of information
requirements.
AGENCY:
OSHA is announcing that
OMB approved the collection of
information requirements contained in
the General Working Conditions
Standard under the Paperwork
Reduction Act of 1995. The OMB
approval number is 1218–0259.
DATES: The rule is effective January 3,
2012. The final rule, published May 2,
2011 (76 FR 24576), became effective
and enforceable on August 1, 2011,
except for the provisions in § 1915.89,
which became effective and enforceable
on October 31, 2011.
FOR FURTHER INFORMATION CONTACT:
Theda Kenney, OSHA, Directorate of
Standards and Guidance, U.S.
Department of Labor, Room N–3609,
200 Constitution Avenue NW.,
Washington, DC 20210; telephone (202)
693–2222.
SUPPLEMENTARY INFORMATION: OSHA
published a final rule for General
Working Conditions in Shipyard
Employment on May 2, 2011 (76 FR
24576), updating existing requirements
to reflect advances in industry practices
and technology, consolidating some
general safety and health requirements
into one subpart, and providing
hazardous energy protection not
addressed in the existing standard.
As required by the Paperwork
Reduction Act of 1995, the Federal
SUMMARY:
E:\FR\FM\03JAR1.SGM
03JAR1
Agencies
[Federal Register Volume 77, Number 1 (Tuesday, January 3, 2012)]
[Rules and Regulations]
[Pages 7-18]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2011-33554]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Food and Drug Administration
21 CFR Parts 606, 610, and 640
[Docket No. FDA-2003-N-0097] (Formerly 2003N-0211)
Revisions to Labeling Requirements for Blood and Blood
Components, Including Source Plasma
AGENCY: Food and Drug Administration, HHS.
ACTION: Final rule.
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SUMMARY: The Food and Drug Administration (FDA) is revising the
labeling requirements for blood and blood components intended for use
in transfusion or for further manufacture by combining, simplifying,
and updating specific regulations applicable to labeling and circulars
of information. These requirements will facilitate the use of a
labeling system using machine-readable information that would be
acceptable as a replacement for the ``ABC Codabar'' system for the
labeling of blood and blood components. FDA is taking this action as a
part of its efforts to comprehensively review and, as necessary, revise
its regulations, policies, guidances, and procedures related to the
regulation of blood and blood components. This final rule is intended
to help ensure the continued safety of the blood supply and facilitate
consistency in labeling.
DATES: This rule is effective July 2, 2012.
FOR FURTHER INFORMATION CONTACT: Benjamin Chacko, Center for Biologics
Evaluation and Research (HFM-17), Food and Drug Administration, 1401
Rockville Pike, Suite 200N, Rockville, MD 20852-1448, (301) 827-6210.
SUPPLEMENTARY INFORMATION:
I. Introduction
A. Background
This rule represents FDA's efforts to revise the regulations for
blood and blood components. The rule consolidates most labeling
requirements for blood and blood components, including Source Plasma,
into one section of the Code of Federal
[[Page 8]]
Regulations (CFR). The rule also updates the regulations applicable to
circulars of information.
In the Federal Register of July 30, 2003 (68 FR 44678), FDA
published a proposed rule that proposed revisions to update
requirements for storage and shipment of blood and blood components.
FDA received numerous comments in response to these proposals, many of
which opposed the changes primarily due to economic concerns. FDA has
reviewed these comments and appreciates the concerns raised, and is
currently reevaluating these proposals. (See discussion in section II.B
of this document.)
B. Development of the International Society of Blood Transfusion Code
(ISBT) 128
In the Federal Register of August 30, 1985 (50 FR 35472), we
published a notice of availability entitled ``Guideline for the Uniform
Labeling of Blood and Blood Components,'' which described the uniform
container label for blood and blood components and recommended labels
that incorporated barcode symbology known as ``ABC Codabar.''
Because the ``ABC Codabar'' system was becoming outdated, we asked
the Blood Products Advisory Committee (BPAC), on March 23, 1995,
whether there was persuasive evidence for us to allow conversion from
``ABC Codabar'' to International Society of Blood Transfusion Code 128
(ISBT 128), according to the International Council for Commonality in
Blood Banking Automation (ICCBBA) proposed timetable. The BPAC voted in
favor of accepting the proposed timetable by ICCBBA. The BPAC meeting
transcript also indicates the Department of Defense's and the blood
industry's, including America's Blood Centers' and AABB's (formerly
known as American Association of Blood Banks), support of the move to
ISBT 128 for blood and blood components for transfusion.
After the BPAC meeting, ICCBBA developed and submitted to FDA a
draft standard entitled ``United States Industry Consensus Standard for
the Uniform Labeling of Blood and Blood Components Using ISBT 128,''
Version 1.2.0 (draft standard), recommending that ISBT 128 replace
``ABC Codabar.'' In the Federal Register of November 27, 1998 (63 FR
65600), we announced the availability of the draft standard and
requested public comment on both the use of ISBT 128 and timeframes for
implementation.
The ICCBBA revised the draft standard in response to public comment
and submitted to FDA a revised draft standard entitled ``United States
Industry Consensus Standard for the Uniform Labeling of Blood and Blood
Components Using ISBT 128,'' Version 1.2.0, dated November 1999 (the
Version 1.2.0 Standard). We reviewed the new draft standard, the
comments received in response to the Federal Register notice of
November 27, 1998, and the Version 1.2.0 Standard, and concluded that
conformance to the Version 1.2.0 Standard, prepared and reviewed by
ICCBBA, would help facilitate the use of a uniform container label for
blood and blood components. Thus, in the Federal Register of June 6,
2000 (65 FR 35944), we announced the availability of a final guidance
entitled ``Guidance for Industry: Recognition and Use of a Standard for
the Uniform Labeling of Blood and Blood Components'' dated June 2000,
which recognized as acceptable, except where inconsistent with the
regulations, use of the Version 1.2.0 Standard and the implementation
of the ISBT 128 uniform labeling system. This guidance identified two
inconsistencies between the Version 1.2.0 Standard and the requirements
in part 606 (21 CFR part 606) at Sec. 606.121; the first inconsistency
concerned the requirement that on container labels for Whole Blood the
name of the applicable anticoagulant must immediately precede the
proper name of the product (Sec. 606.121(e)(1)(ii)); and the second
inconsistency concerned the requirement that the proper name of the
product and any appropriate modifiers must be printed in solid red
(Sec. 606.121(d)(2)).
In the Federal Register of August 19, 1999 (64 FR 45366), we
published a direct final rule entitled ``Revisions to the Requirements
Applicable to Blood, Blood Components, and Source Plasma,'' which
amended Sec. 606.121(d)(2) by adding ``or in solid black,'' thereby
eliminating the inconsistency between the Version 1.2.0 Standard and
Sec. 606.121(d)(2), which had previously required that any modifier be
printed in solid red.
In the ``Guidance for Industry: Recognition and Use of a Standard
for Uniform Blood and Blood Component Container Labels'' dated
September 2006 (https://www.fda.gov/downloads/BiologicsBloodVaccines/GuidanceComplianceRegulatoryInformation/Guidances/Blood/ucm079004.pdf),
we recognized as acceptable, except where inconsistent with the
regulations, use of the ``United States Industry Consensus Standard for
the Uniform Labeling of Blood and Blood Components Using ISBT 128''
version 2.0.0, dated November 2005 (the Version 2.0.0 Standard). In the
guidance, we noted that the Version 2.0.0 Standard revised the Version
1.2.0 Standard and that there remained an inconsistency between the
Version 1.2.0 Standard, the Version 2.0.0 Standard and the requirements
at Sec. 606.121(e)(1)(ii). Since that guidance was issued, we have
identified another inconsistency between the requirements under Sec.
606.121(c)(2) and the Version 2.0.0 Standard regarding the requirement
to include the FDA assigned registration number on blood and blood
component labels. This final rulemaking addresses these inconsistencies
by eliminating the existing inconsistencies between the Version 2.0.0
Standard and the requirements at Sec. 606.121(c)(2) and (e)(1)(ii).
(FDA has verified the Web site addresses in this document, but FDA
is not responsible for subsequent changes after this document publishes
in the Federal Register.)
C. The Proposed Rule
In the Federal Register of July 30, 2003 (68 FR 44678), we
published a proposed rule entitled ``Revisions to Labeling and Storage
Requirements for Blood and Blood Components, Including Source Plasma''
(the proposed rule), to combine, simplify and update specific
regulations applicable to container labeling and instruction circulars
for all human blood and blood components, including Source Plasma. We
also proposed to revise the shipping and storage requirements for
certain human blood and blood components. Furthermore, we proposed the
use of a labeling system using machine-readable information that would
be acceptable as a replacement for the ``ABC Codabar'' system for
labeling blood and blood components, and stated that we would also
address the existing inconsistencies between the Version 1.2.0
Standard, and the existing regulations as described in section I.B of
this document. We also intended to provide more flexibility for
inventory management, and to update current requirements designed to
ensure potency of the blood components over time by revising the
current storage and shipping temperature requirements for frozen
noncellular blood components, both for transfusion and for further
manufacture (e.g., Cryoprecipitated Antihemophilic Factor, Fresh Frozen
Plasma, and Source Plasma).
We note that the proposed rulemaking inadvertently included
proposed changes to Sec. 606.121(c)(13) (68 FR 44678 at 44686), which
were inconsistent with a previously proposed amendment to Sec.
606.121(c)(13) in an earlier, related proposed rule entitled ``Bar Code
Label Requirement for
[[Page 9]]
Human Drug Products and Blood'' that published in the Federal Register
of March 14, 2003 (68 FR 12499). To eliminate any confusion, we
published a correction to the proposed rule in the Federal Register of
October 27, 2003 (68 FR 61172), and published the related, final rule
entitled ``Bar Code Label Requirements for Human Drug Products and
Blood'' in the Federal Register of February 26, 2004 (69 FR 9120). We
also note that the proposed rulemaking inadvertently omitted the
requirement in current 21 CFR 640.70(a)(7) that requires that for
Source Plasma, in the case of immunized donors, the label must state
the immunizing antigen. In this final rule, we have corrected this
omission and have placed this requirement in redesignated Sec.
606.121(e)(5)(vi).
Regarding the term ``communicable disease testing,'' used in this
final rule, we noted in the proposed rule (68 FR 44678 at 44684) that
the terms ``infectious agent testing'' and ``communicable disease
testing'' (used interchangeably in the proposed rule and in guidance
documents) refer to the same testing performed in accordance with Sec.
610.40 (21 CFR 610.40). We also noted that the term ``infectious
agent'' is used rather than ``communicable disease agent'' for
consistency with labeling approved by the Director, Center for
Biologics and Evaluation Research (CBER), for the Version 1.2.0
Standard and the ``ABC Codabar'' System. In this final rule, as well as
in the Version 2.0.0 Standard, the terms ``infectious agent testing''
and ``communicable disease testing'' continue to be used
interchangeably and refer to the same testing performed in accordance
with Sec. 610.40.
II. Revisions to the Proposed Rule
A. Requirements Finalized in This Rule
This rule:
Finalizes, in part, the proposed requirements for labeling
for blood and blood components intended for use in transfusion or
further manufacture by all blood establishments, and specific
regulations applicable to container labeling and circulars of
information;
Eliminates the two remaining inconsistencies between the
Version 2.0.0 Standard and the regulations, described in section I.B of
this document;
Facilitates the use of a labeling system using machine-
readable information that would be acceptable as a system for labeling
blood and blood components, and the use of new labeling systems that
may be developed in the future;
Consolidates regulations applicable to labeling standards
so that most labeling requirements for all blood and blood components,
including Source Plasma, found previously in Sec. Sec. 606.121 and
640.70, can now be found in Sec. 606.121;
Updates some of the consolidated regulations;
Replaces ``shall'' with ``must'' in all places wherever it
appears in the regulations;
Retitles part 606, subpart G; and
Makes other, necessary conforming changes, and technical
amendments.
B. Requirements Not Finalized in This Rule
At this time, we are not finalizing the proposed requirements for
storage and shipping temperatures of certain human blood and blood
components, including Source Plasma, because we are continuing to
reevaluate these proposals, taking into account the adverse comments
received. Under the proposed rule, we proposed revisions to the
labeling requirements regarding storage and shipping temperatures for
frozen noncellular blood components in current part 640 (21 CFR part
640) at Sec. 640.70(a)(3) and (b). We also proposed revisions to
storage and shipping temperatures in current Sec. Sec. 600.15 (21 CFR
600.15), 610.53, 640.34, 640.54, 640.69, and 640.76 to help ensure the
potency of the frozen noncellular blood components and for consistency
between the labeling regulations and the regulations concerning
shipping and storage temperatures of frozen noncellular blood
components. By updating the storage and shipping temperature
requirements and addressing as many labeling changes as possible at one
time, we had believed that the proposed rule would limit the number of
times establishments would have to revise container labels.
However, we have concluded, based on comments received, that we
should reevaluate the proposed revisions to the requirements for
storage and shipping temperatures. For example, we received comments
from the plasma fractionation industry stating that the proposed
freezing/storage temperature of -30 [deg]C was below the temperature
that would be acceptable to preserve product activity, would be very
costly to implement, and would pose a safety hazard to employees
working in that environment. In the Federal Register of August 9, 2004
(69 FR 48250), we announced a public workshop entitled ``Development of
Plasma Standards'' that was held August 31 and September 1, 2004. The
objective of the workshop was to gather information on current industry
practices that are in place for the manufacture of plasma. We also
discussed this issue at a March 17, 2005, BPAC meeting and at an April
2, 2009, BPAC meeting.
FDA intends to consider revising storage requirements in the
future, based on our review of scientific literature, data from other
regulatory authorities and the plasma fractionation industry, and input
from BPAC. Based on the information received, we intend to develop
standards for the preparation, labeling, storage, and shipping of
frozen noncellular blood components for transfusion and for further
manufacture.
C. Conforming and Clarifying Changes
This final rule removes Sec. 640.70 from the CFR, and accordingly,
we have made conforming changes to Sec. 610.40(h)(2)(ii)(B) and Sec.
640.74(b)(4) both of which currently reference Sec. 640.70. In Sec.
610.40(h)(2)(ii)(B), we have deleted the reference to Sec. 640.70. In
Sec. 640.74(b)(4), we have deleted the reference to Sec. 640.70(a)
and replaced it with Sec. 606.121 and have deleted the reference to
Sec. 640.70(a)(3) and replaced it with Sec. 606.121(e)(5)(ii).
We also made a conforming change to Sec. 610.40(i) to cross-
reference another existing requirement for a serological test for
syphilis under Sec. 640.65(b)(1).
We also made a conforming change to Sec. 606.121(c)(13)(iii)(D) to
cross-reference other existing requirements under Sec. 606.121(c)(9)
and Sec. 606.121(i)(5).
We are clarifying proposed Sec. 606.121(i)(4) by removing the
phrase ``unless exempt under'' to ``except as provided in.'' This
clarifying change will not affect the substantive requirements in this
regulation.
Further, we made two clarifying changes to Sec. 606.122(f) by
changing ``statements'' to ``statement'' and replacing the period after
``Warning'' with a colon, so that the provision now reads in its
entirety, ``The statement: `Warning: The risk of transmitting
infectious agents is present. Careful donor selection and available
laboratory test do not eliminate the hazard.''
D. Technical Amendment
We have made a technical amendment to Sec. 606.170 to clarify that
reports of the investigation of a fatality must be submitted to CBER
either by mail, facsimile, or electronically transmitted mail; and to
provide mailing address information for the Director, Office of
Compliance and Biologics Quality, CBER.
Further, we have made a technical amendment to Sec.
606.121(e)(2)(i) to require that with the exception of those
[[Page 10]]
products listed in Sec. 606.121(e)(2), red blood cell product labels
must include the type of additive solution with which the product was
prepared.
III. Comments on the Proposed Rule and FDA's Responses
We received approximately 24 comments on the proposed rule. These
comments were received from blood establishments, private and public
interest groups, and the general public. All of the comments expressed
opinions on the proposed revisions to the storage and shipping
temperature requirements; about 12 of the comments commented on the
proposed labeling requirements. Because we are not finalizing the
proposed storage and shipping temperature requirements at this time,
this document does not discuss those issues. This document discusses
information relevant to and comments concerning the proposed revisions
to the labeling requirements. To make it easier to identify comments
and our responses, the word ``Comment,'' in parentheses, will appear
before the description of comments, and the word ``Response,'' in
parentheses, will appear before our responses.
A. General
(Comment 1) Numerous comments supported the proposed revisions to
consolidate, simplify and update the regulations applicable to
container labeling and the instruction circular; one comment stated
that the changes were ``long overdue.'' Several comments applauded our
efforts to develop a proposed rule that will facilitate the
implementation of ``machine-readable'' bar code standards and strongly
endorsed the use of ISBT 128 as a unifying bar code standard for blood
and blood components, which will improve patient safety. In addition,
one of these comments noted that one bar code standard would lower the
implementation costs related to the standard and would allow for the
exchange of inventories so that the needs of patients everywhere could
be more easily met.
(Response) We appreciate these supportive comments. We agree that
this rule facilitates the use of the ISBT 128 machine readable labeling
system for blood components by eliminating FDA requirements that are
inconsistent with the use of the ISBT system. We note that once this
rule is in effect, licensed establishments will no longer need to
request a variance from the regulations to fully implement the ISBT
system--thus we anticipate that the new rule will save both industry
and FDA resources. In addition, the rule updates current labeling
requirements to ensure appropriate and complete labeling of all blood
and blood components for infectious disease test results, including
recovered plasma for further manufacturing. In these ways, the rule
will support the safety of the nation's blood supply.
At the same time, we are preserving for industry the option of
using the older labeling system, ``ABC Codabar.''
(Comment 2) One comment expressed concern that consolidating the
labeling requirements for Source Plasma and other blood components into
the same CFR section may make it more difficult to identify the
applicable labeling requirements, and suggested as an alternative that
we consolidate requirements into a single section with a subsection
dedicated to requirements specific to Source Plasma. Another comment
noted that consolidating requirements into one section has both
advantages and disadvantages. This comment noted that the manufacture
of Source Plasma is significantly different from the manufacture of
blood components for transfusion. The comment also noted that other
blood products, which are markedly different from blood components for
transfusion, have separate labeling requirements in the CFR (e.g.,
Albumin (part 640, subpart H), Plasma Protein Fraction (part 640,
subpart I), and Immune Globulin (part 640, subpart J)). The comment
noted that for consistency, we should maintain separate labeling
requirements for Source Plasma in part 640, subpart G, and instead
revise Sec. 640.70 to require labeling statements based on
communicable disease testing.
Two comments noted that a requirement for all test results to be
recorded on the product label is not consistent with current industry
practice for recovered plasma. See response to comment 8 for further
information.
(Response) One purpose of the proposed rule was to consolidate the
labeling regulations that apply to blood and blood components in one
place in the CFR, including blood components that are used for further
manufacture. Not all blood components that are used for further
manufacture currently have additional standards in part 640, e.g.,
recovered plasma. In Sec. 606.121, we have consolidated the labeling
requirements for blood and blood components intended for use in
transfusion or further manufacture. To clarify this point, in Sec.
606.121(a), we have deleted the phrase ``including Source Plasma'' from
the proposed language and added instead ``intended for use in
transfusion or further manufacture.'' We have also revised Sec.
606.121(c)(11) to require that if the product is intended for further
manufacturing use, a statement listing the results of all the tests for
communicable disease agents required under Sec. 610.40 for which the
donation has been tested and found negative must be on the container
label; except that the container label for Source Plasma is not
required to list the negative results of serological syphilis testing
under Sec. 610.40(i) and Sec. 640.65(b).
In response to comments regarding current industry practice for
negative labeling of recovered plasma for further manufacture, we
believe that it is current industry practice to include the
communicable disease test results for recovered plasma on the container
label. See the response to comment 8 for full details.
(Comment 3) One comment requested that in addition to the revisions
in this final rule, we make changes to further streamline the labeling
submission process for on-demand ISBT 128 labels.
(Response) The comment is beyond the scope of this final rule.
However, we will consider the comments on this issue at a later date.
(Comment 4) One comment requested more flexibility on tie-tags used
for autologous donations, suggesting that a computer system-generated
ABO blood group and Rh type (ABO/Rh) label be applied to the tie-tag as
opposed to the current practice of hand writing the ABO/Rh result on
the tag and on the ``For Autologous Use'' label. The comment stated
that this change would eliminate the need for handwritten information,
thus reducing the likelihood of human error, thereby improving patient
safety.
(Response) The comment regarding the use of a computer system-
generated ABO/Rh label is beyond the scope of this final rule. However,
we note that in the final rule published in the Federal Register of
February 26, 2004 (69 FR 9120), entitled ``Bar Code Label Requirements
for Human Drug Products and Biological Products,'' we revised Sec.
606.121(c)(13) to require that the ABO blood group and Rh type of the
donor be present in machine-readable format on the container label of
all blood and blood components, including autologous units. This
requirement is consistent with ISBT 128 standards but requires those
manufacturers using ``ABC Codabar'' to affix an ABO/Rh bar code label
to the ``For Autologous Use Only'' label on blood and blood components
bearing the autologous label. In this final rule, we have amended Sec.
606.121(i)(5) to permit each container label of blood and blood
components intended for autologous use
[[Page 11]]
and obtained from an unsuitable donor or one who is reactive for
evidence of infection due to communicable disease agents under Sec.
610.40 to include the ABO and Rh blood group and type. However, such
labeling is not required.
B. 21 CFR 606.121(b)
The proposed rule amended Sec. 606.121(b) by adding the phrase
``with any appropriate modifiers and attributes'' to clarify that the
label provided by the collecting facility may be altered under certain
circumstances and may be altered multiple times to adequately identify
the contents of a container. Examples of appropriate modifiers include
``washed,'' ``frozen,'' and ``liquid.'' Examples of appropriate
attributes include ``irradiated'' and ``divided,'' which would indicate
a process change. We have finalized these requirements as proposed,
including the conforming amendments to Sec. Sec. 606.121(c)(1) and
606.121(d)(2). In addition, we have added the clarifying phrases ``of
the product'' and ``considered finished products'' to Sec. 606.121(b).
In this section III.B, we describe two examples of circumstances where
it is acceptable to alter the label of blood components as finished
products after they have been prepared. We note that it is appropriate
to revise the label each time, after the finished product has been
prepared.
In the preamble of the final rule entitled ``Current Good
Manufacturing Practice for Blood and Blood Components; Uniform Blood
Labeling'' published in the Federal Register of August 30, 1985 (50 FR
35458), we responded to a comment (comment number 2) that suggested
that the only instance in which labels are permitted to be altered
pursuant to Sec. 606.121(b) is when blood components are removed from
the product. In the response, we noted, that there are certain cases
when no blood components are removed from a unit, but the unit may
nonetheless require relabeling. Id. at 35459. For example, such
relabeling would be appropriate when the product is further processed
by freezing, pooling, washing, or irradiating, provided that the
establishments have a validated process for this additional processing.
The original label would need to be modified to include the additional
information and then reprinted and the product relabeled, i.e., a new
label placed over the original label, to accurately identify the
product.
Another specific circumstance in which the label of a blood product
may be altered under Sec. 606.121(b) is when the original label may
need to be recreated because the original bag is destroyed while the
product is further processed by, for example, freezing, pooling,
washing, or irradiation. The recreated label may be placed on the new
bag under applicable regulations and the establishment's standard
operating procedures.
C. 21 CFR 606.121(c)(2)
In the proposed rule, we proposed amending Sec. 606.121(c)(2) by
replacing ``registration number'' with ``unique facility identifier.''
Although, as we discussed in the preamble to the proposed rule (68 FR
44678 at 44683), the FDA-assigned registration number is acceptable as
a ``unique facility identifier,'' we wanted to be able to provide for
the use of other recognized donation facility identification numbers,
such as the ISBT facility code (which includes machine-readable
information). In addition, we proposed removing the requirements of
current Sec. 640.70(a)(10) for ``name, address, and license number''
on the Source Plasma label because they are included in proposed Sec.
606.121(c)(2).
(Comment 5) One comment suggested that this change imposes an
additional requirement on collectors of Source Plasma operating
multiple sites under a single license.
(Response) FDA believes that the final rule addresses this concern.
In consideration of this comment, we are not requiring the container
label for blood components for further manufacture to contain a unique
facility identifier at this time, because we believe that the blood
establishment's FDA approved product label contains sufficient
information to permit identification of the collection facility.
Regarding Source Plasma, we have learned that most collection
facilities include a unique facility identifier on the container label.
We agree that this is useful information for identifying the location
where the Source Plasma was collected.
The final rule requires a unique facility identifier for the
container label of blood and blood components intended for transfusion,
to aid in identifying the location where the blood or blood component
was collected or processed. We note that the final rule provides
flexibility by using the term ``unique facility identifier,'' which may
be satisfied by using an establishment's registration number, the FDA
establishment identifier, an ISBT facility code, or other designation
that will allow identification of the specific location where the blood
or blood component was collected or processed. For example, a blood
establishment may incorporate its unique facility identifier into the
blood component donor, lot, or pool number and use a validated computer
or other recordkeeping system that will enable identification of the
facility that collected that blood or blood component.
(Comment 6) One comment expressed concern that their current
approved labels do not contain a unique site specific identifier that
was assigned by FDA, other than the license number, and that the
effective date for the final rule should provide adequate time for
implementation to allow for label design, acquisition, procedural
changes, and depletion of available stock to minimize transition costs.
(Response) Anticipating the need to deplete existing label stock,
the effective date for the final rule (refer to section VIII of the
proposed rule) (68 FR 44678 at 44685) provides reasonable time for use
of the existing label stock. The final rule becomes effective 180 days
after the date of publication in the Federal Register.
D. 21 CFR 606.121(c)(10)
The proposed rule combined current Sec. 606.121(c)(11) and part of
current Sec. 640.70(a)(2) and redesignated the combined regulations as
proposed Sec. 606.121(c)(10). In addition, FDA proposed to revise
Sec. 606.121(c)(10) by adding a phrase to the first sentence to
clarify that blood and blood components intended for further
manufacture are subject to these requirements. Furthermore, FDA
proposed to revise Sec. 606.121(c)(10) by adding an alternative
warning statement and provided for the use of ``other cautionary
statements as approved by CBER.'' FDA now is finalizing the above
amendments as proposed (including deleting current Sec.
606.121(e)(5)(ii)), because it is now redundant in light of new Sec.
606.121(c)(10)).
(Comment 7) Two comments suggested that it is difficult to select
the proper cautionary statement to use because information regarding
cautionary statements can be found in other sections of the CFR, as
well as in certain FDA guidance documents.
(Response) We acknowledge that the circumstances surrounding which
cautionary statement to use may vary. We believe that the consolidation
of the labeling requirements in this rulemaking for blood and blood
components for further manufacture, including Source Plasma, should
enhance industry's ability to select the appropriate cautionary
language. We also note that reference 1 and reference 2 to this
rulemaking provide general guidelines about the uniform labeling of
blood and blood components. Further,
[[Page 12]]
we suggest that the commenters may want to pose any specific questions
to CBER to obtain further guidance.
E. 21 CFR 606.121(c)(11)
We had proposed to redesignate and combine current Sec. Sec.
640.70(a)(8) and (a)(11) as Sec. 606.121(c)(11) and to revise
redesignated Sec. 606.121(c)(11) to require labeling statements
indicating the results of communicable disease tests performed. The
proposed change provided that the labeling requirements apply to all
blood and blood components for further manufacture, including Source
Plasma, and would require establishments to label products for further
manufacture with the results of communicable disease testing for which
the donation has been tested and found negative.
(Comment 8) Some comments expressed concern regarding the resulting
burdens from consolidating previously referenced requirements into
Sec. 606.121. One comment requested that Sec. 606.121(c)(11) be re-
worded to indicate that communicable disease tests performed on a
sample from the donor of the unit are listed in the current circular of
information, thus providing a much simpler and more flexible method of
meeting labeling requirements without the expense of constantly
changing labels. Additionally, the comment stated that use of the
circular of information would also address concerns regarding the
shipment of positive units for further manufacture, by labeling only
the positive units or alternatively recommended continuing the current
method of noting ``positives'' on the shipping form.
In addition, as discussed previously, regarding recovered plasma,
two comments stated that a requirement for all test results to be
recorded on the product label is not consistent with current industry
practice. The comments indicated that to require constant updating of
labels to report all negative test results is counterproductive to the
positive labeling aspects of the proposed rule, and requested that this
requirement be deleted from the final rule.
(Response) FDA disagrees with the comments related to the use of
the circular of information to list communicable disease test results.
We believe that it is not appropriate to re-word proposed Sec.
606.121(c)(11) to require that information on communicable disease
testing performed on components intended for further manufacture be
included in the circular of information because the circular of
information applies only to transfusable products and not to products
intended for further manufacture.
We note that we have periodically addressed the uniformity of
labeling. For example, we announced the availability of the final
guideline entitled ``Guideline for Uniform Labeling of Blood and Blood
Components'' dated August 1985, which described acceptable criteria for
labels consistent with current good manufacturing practice regulations
for blood and blood components (part 606) (https://www.fda.gov/downloads/BiologicsBloodVaccines/GuidanceComplianceRegulatoryInformation/Guidances/Blood/UCM080974.pdf
). The guideline included illustrated labels for certain blood
components used for further manufacture (e.g., Source Plasma, recovered
plasma, and Source Leukocytes), that had been reviewed and approved by
FDA. We also issued ``Guidance for Industry: Recognition and Use of a
Standard for Uniform Blood and Blood Component Container Labels'' dated
September 2006, which recognizes the ``United States Industry Consensus
Standard for the Uniform Labeling of Blood and Blood Components Using
ISBT 128,'' dated November 2005, as an acceptable standard for blood
and blood component container labels, except where inconsistent with
the regulations. (https://www.fda.gov/downloads/BiologicsBloodVaccines/GuidanceComplianceRegulatoryInformation/Guidances/Blood/UCM079159.pdf
). As discussed in section I.B of this document, we further note that
this final rulemaking addresses the inconsistencies that existed.
FDA also disagrees with the comments concerning the labeling of
recovered plasma because we believe they are incorrect. We believe it
is the usual and customary practice of the blood industry to label the
container label of blood and blood components for further manufacture
with the negative communicable disease test results of all the tests
for communicable disease agents required under Sec. 610.40, except for
Source Plasma with respect to serological syphilis testing. We are
therefore finalizing the requirement in this rulemaking that the label
of blood and blood components for further manufacture must include a
statement listing the results of all the tests for communicable disease
agents required under Sec. 610.40 for which the donation has been
tested and found negative except that the label for Source Plasma is
not required to list the negative results of serological syphilis
testing under Sec. Sec. 610.40(i) and 640.65(b).
(Comment 9) One comment noted that consistent with Sec. Sec.
610.40(i) and 640.65(b)(1), Source Plasma is unique because a
serological test for syphilis is performed at intervals of no more than
4 months, rather than at each individual donation. The comment
requested clarification on whether syphilis is considered a
``communicable disease agent'' and if the labeling of serological
syphilis testing results is required on units of Source Plasma. This
comment also expressed the concern that requiring syphilis test results
on each Source Plasma unit would be burdensome for industry because it
is current industry practice to pre-label Source Plasma with required
communicable disease testing results.
(Response) As noted previously in the response to comment 8, we are
not finalizing Sec. 606.121(c)(11) as proposed. We will therefore
answer this comment in light of the revised provisions of Sec.
606.121(c)(11). Syphilis is deemed to be a communicable disease agent;
the testing requirements for which are included in part 610, subpart E
(Testing Requirements for Communicable Disease Agents), specifically
Sec. 610.40(i). Section 610.40(i) incorporates the requirement in
Sec. 640.65(b) to test a Source Plasma donor using a serological test
for syphilis at the donor's initial examination and at least once every
four months thereafter. (More limited testing for Source Plasma
reflects the reduced risk presented by syphilis infected collections of
Source Plasma. In an FDA Compliance Policy Guide revised in 1995, FDA
observed that ``the disease-causing spirochetes are destroyed during
the storage and/or fractionation of the [source] plasma.'') \1\
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\1\ https://www.fda.gov/ICECI/ComplianceManuals/CompliancePolicyGuidanceManual/ucm073876.htm.
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Under Sec. 606.121(c)(11) as finalized, the label for blood and
blood components intended for further manufacture must list the results
of all the tests for communicable disease agents required under Sec.
610.40 for which the donation has been tested and found negative;
except that the container label for Source Plasma is not required to
list the negative results of serological syphilis testing under Sec.
610.40(i) and Sec. 640.65(b). This is because the regulations do not
require that each Source Plasma donation be tested for syphilis. In the
absence of test results for each donation (e.g., in connection with
donations made in month three) or where testing for syphilis was
performed and the test was negative, the label is silent. When testing
is performed and is reactive for
[[Page 13]]
syphilis, the label for the unit associated with the positive test and
the label for the unit of any donation(s) made after obtaining the test
results must appropriately disclose that the Source Plasma tested
reactive by a serologic test for syphilis as described in Sec.
606.121(e)(5)(iv).
More generally, concerning the pre-labeling of Source Plasma, it is
FDA's expectation that tests for required infectious disease tests are
completed prior to shipment of the Source Plasma for further
manufacture to the fractionator or for distribution. However, we also
recognize that in certain circumstances, nucleic acid test (NAT)
testing of Source Plasma may take an extended period to resolve
positive NAT pools to identify an individual positive unit.
Additionally, we recognize the difficulty of placing a ``label'' on a
frozen product. We note that Source Plasma may be labeled and then may
be shipped for pre-release storage at another facility while still
under the manufacturer's control due to the manufacturer's storage
limitations. This raises the question of whether it is acceptable for a
manufacturer to pre-label (at the time of collection) Source Plasma as
``tested and found negative'' while performing NAT testing and shipping
such products under quarantine (i.e., while still under the
manufacturer's control) and delaying release and distribution until all
the test results are obtained.
Under the revised regulation, if the product is intended for
further manufacturing use, a statement listing the results of all the
tests for communicable disease agents required under Sec. 610.40 for
which the donation has been tested and found negative must be listed on
the container label; except that the container label for Source Plasma
is not required to list the negative results of serological syphilis
testing under Sec. 610.40(i) and Sec. 640.65(b). In addition, blood
and blood components intended for further manufacture must be labeled
in accordance with Sec. 610.40, when the donation has been tested and
demonstrates evidence of infection due to a communicable disease
agent(s).
Under Sec. 606.121(c)(11) as finalized, it is acceptable for
Source Plasma manufacturers to place the label indicating negative
communicable disease test results on the product prior to completion of
communicable disease testing (pre-label) as long as either (1) The unit
is shipped to a storage facility and remains under quarantine control
by the collection establishment until all testing is completed and
accurately reflected on the label or (2) the unit is not released and
distributed into interstate commerce until the results from all
communicable disease tests are obtained and accurately reflected on the
label. Thus, the requirements under Sec. Sec. 606.121(c)(11) and
610.40 are not fulfilled until the container label accurately lists the
results obtained from all communicable disease testing required under
Sec. 610.40. At that time, the product is ready for distribution and
release into interstate commerce.
In the event that a shipped unit is pre-labeled with a negative
test result but is later found positive upon completed testing, that
unit must be relabeled in accordance with Sec. 610.40, including
obliteration of the negative result.
F. 21 CFR 606.121(e)(2)(i) and 21 CFR 606.121(e)(5)(vi)
In finalizing this rulemaking, we have amended Sec.
606.121(e)(2)(i) to require that with the exception of those products
listed in Sec. 606.121(e)(2), red blood cell product labels must
include the type of additive solution with which the product was
prepared as this information is useful when making determinations in
connection with the shelf life of the product. For example, red cell
additive solutions (e.g., AS-1, AS-3, AS-5) provide nutrients to the
blood components which in turn allows for an extended shelf life. We
note that the labeling of the container with the additive solution is
also industry practice.
We proposed to redesignate current Sec. 640.70(a)(7) as Sec.
606.121(e)(5)(vi). We also proposed to update redesignated Sec.
640.70(a)(7) to broaden the labeling requirements to include
collections from donors who are not immunized but are in specific
collection programs. The proposal replaced the term ``normal donor''
with the term ``nonimmunized donor.'' After consideration, we have
determined that ``nonimmunized donor'' is not a recognized term, and we
will continue to use the term ``normal donor.''
G. 21 CFR 606.122
We proposed to amend Sec. 606.122 by revising the introductory
paragraph and paragraphs (e), (f), and (m). We received comments only
on the heading of this regulation, ``Instruction circular,'' which we
did not propose to change, and paragraphs (e) and (m).
1. Title for Sec. 606.122
(Comment 10) A few comments desired consistency between Sec.
606.121(c)(8)(ii), which refers to the ``Circular of Information,'' and
Sec. 606.122, which refers to the ``Instruction circular.'' One
comment suggested revising Sec. 606.121(c)(8)(ii) to use the same
language in the AABB ``Standards for Blood Banks and Transfusion
Services'': ``See Circular of Information for the Use of Human Blood
and Blood Components.''
(Response) We agree that there should be consistency between
Sec. Sec. 606.121(c)(8)(ii) and 606.122. We are therefore revising the
title of Sec. 606.122 and the corresponding language in Sec. Sec.
606.122(k), (l), (m), and (n) by replacing ``Instruction circular''
with ``Circular of Information'' to be consistent with the wording
required on labels of blood and blood components for transfusion, as
illustrated in the ``Guideline for the Uniform Labeling of Blood and
Blood Components'' and the ``United States Industry Consensus Standard
for the Uniform Labeling of Blood and Blood Components Using ISBT
128,'' dated November 2005, (https://www.fda.gov/downloads/BiologicsBloodVaccines/GuidanceComplianceRegulatoryInformation/Guidances/Blood/UCM079159.pdf). However, although it is a common
industry practice for blood establishments to refer to the ``Circular
of Information for the Use of Human Blood and Blood Components,'' we
decline to change Sec. 606.121(c)(8)(ii) as suggested because existing
regulations do not preclude blood establishments from creating their
own circulars of information to address the labeling standards required
in Sec. 606.122. Moreover, Sec. 606.121(c)(8)(ii) is consistent with
labeling approved by the Director, CBER, i.e., ISBT 128 and ``ABC
Codabar.''
2. 21 CFR 606.122(e) and 21 CFR 606.122(f)
We proposed that the instruction circular contain statements
regarding the results of each infectious agent for which the blood was
tested, including all FDA required tests, and found negative. We have
decided to clarify that under Sec. 606.122(e), a product intended for
transfusion must include a statement that the product was prepared from
blood that was found negative when tested for communicable disease
agents as required under Sec. 610.40 (include each test that was
performed). We also proposed to amend Sec. 606.122(f) by updating the
warning statement to reflect the risk associated with the communicable
disease agents for which testing is currently performed. We have
decided to keep the currently required statement but note that we have
made two clarifying changes to this statement by changing
``statements'' to ``statement'' and replacing the period after
``Warning'' with a colon, so that
[[Page 14]]
the provision now reads in its entirety, ``The statement: `Warning: The
risk of transmitting infectious agents is present. Careful donor
selection and available laboratory tests do not eliminate the
hazard.''' to be consistent with the warning statements reflected in
the current Circular of Information.
(Comment 11) One comment supported the change if they correctly
interpreted ``name each infectious agent'' as requiring a list of
infectious agents, and opined that it is not necessary to ``name'' each
type of test that is performed for each infectious agent. For example,
according to the comment, it is not necessary to list both antibody
tests and nucleic acid tests. Another comment recommended that either
Sec. 606.121(c)(11) or Sec. 606.121(c)(8)(ii) should be revised to
require the label to bear a statement ``See Circular of Information * *
* results of infectious agent testing.''
(Response) We do not agree that the infectious agent need only be
listed once on the labeling for both transfusable products and products
for further manufacturing if the blood or blood component was tested by
different tests for the same infectious agent. We have revised Sec.
606.122(e) to clarify that the circular of information must list the
results of all donor screening tests for communicable disease agents
required under Sec. 610.40 for which the blood or blood component was
tested and found negative (e.g., negative for antibodies to HIV and
Non-reactive for HIV-1 RNA). We interpret ``negative'' to include
``Non-reactive.'' In response to the suggestion to revise Sec.
606.121(c)(11), we refer to our response to comment 8. As noted in that
response, we are not finalizing Sec. 606.121(c)(11) as proposed. We
also believe that it is not practical to revise Sec. 606.121(c)(8)(ii)
to require a statement of all negative test results on the container
label of blood and blood components for transfusion, due to space
limitations on the container label. We believe that the circular of
information is the best place to list this type of information.
3. 21 CFR 606.122(m)(3)
The proposed rule proposed to clarify that the instruction circular
must contain, when applicable, instructions to begin administration of
plasma within ``a specified time'' after thawing.
(Comment 12) One comment requested clarification of Sec.
606.122(m)(3) and suggested that the current statement in the Circular
of Information for the Use of Human Blood and Blood Components,
``Transfusion should be completed within four hours and prior to
component expiration,'' could be used.
(Response) We do not want to establish in regulation a specified
time to begin or complete the transfusion of a plasma component.
Instead, we believe that it is appropriate to provide industry with
increased flexibility for developing and specifying timeframes for
which thawed plasma components can still be used for transfusions if
stored at appropriate temperatures per industry standards. We are
therefore finalizing the amendment to Sec. 606.122(m)(3) as proposed.
H. Concerns About Labeling for Transfusable Products
(Comment 13) One comment asked if manufacturers of licensed
products will have to resubmit labels for approval, citing that such a
requirement would add to the cost of compliance and impact the ability
of some centers to support out-of-state regions in need of blood during
FDA label review/approval process time.
(Response) This rulemaking, in part, updates existing regulations
to be consistent with current practice. Under the final rule, licensed
manufacturers who have FDA approved container labels that meet the
requirements of the final rule do not have to resubmit their labels for
approval. If a manufacturer wishes to make labeling changes, a
supplement submission must be submitted to FDA consistent with the
requirements under Sec. 601.12(f)(1) (21 CFR 601.12(f)(1)).
(Comment 14) One comment expressed concern that the proposed
revision to Sec. 606.121(c)(2) will change the commenter's current FDA
approved labels and will cost blood establishments approximately
$40,000 annually in registration and licensing fees if ISBT or a
similar system is utilized. A substantial additional cost will be
involved in the purchase of printers, scanners, bar code readers,
validation, and training.
(Response) We are not requiring blood establishments to utilize the
ISBT labeling system. Blood establishments may continue to use the
``ABC Codabar'' system. Both of these systems are acceptable labeling
under the bar code requirements.
IV. Legal Authority
FDA is issuing this rulemaking under the biological products
provisions and the communicable diseases provisions of the Public
Health Service Act (PHS Act) (42 U.S.C. 216, 262, 263, 263a, 264,
300aa-25), and the drugs, devices, and general administrative
provisions of the Federal Food, Drug, and Cosmetic Act) (21 U.S.C. 321,
331, 351, 352, 353, 355, 360, 360c, 360d, 360h, 360j, 371, 372, 374 and
381). Under these provisions of the PHS Act and the Federal Food, Drug,
and Cosmetic Act, we have the authority to issue and enforce
regulations designed to ensure that biological products are safe, pure,
potent, and properly labeled, and to prevent the introduction,
transmission, and spread of communicable disease.
V. Analysis of Economic Impacts
FDA has examined the impacts of the final rule under Executive
Order 12866, Executive Order 13563, the Regulatory Flexibility Act (5
U.S.C. 601-612), and the Unfunded Mandates Reform Act of 1995 (Pub. L.
104-4). Executive Orders 12866 and 13563 direct Agencies to assess all
costs and benefits of available regulatory alternatives and, when
regulation is necessary, to select regulatory approaches that maximize
net benefits (including potential economic, environmental, public
health and safety, and other advantages; distributive impacts; and
equity). The Agency believes that this final rule is not a significant
regulatory action under Executive Order 12866.
The Regulatory Flexibility Act requires Agencies to analyze
regulatory options that would minimize any significant impact of a rule
on small entities. Because the requirements of the final rule are
either consistent with industry practice or would be industry practice
absent existing prohibitions, the Agency certifies that the final rule
will not have a significant economic impact on a substantial number of
small entities.
Section 202(a) of the Unfunded Mandates Reform Act of 1995 requires
that Agencies prepare a written statement, which includes an assessment
of anticipated costs and benefits, before proposing ``any rule that
includes any Federal mandate that may result in the expenditure by
State, local, and tribal governments, in the aggregate, or by the
private sector, of $100,000,000 or more (adjusted annually for
inflation) in any one year.'' The current threshold after adjustment
for inflation is $136 million, using the most current (2010) Implicit
Price Deflator for the Gross Domestic Product. FDA does not expect this
final rule to result in any 1-year expenditure that would meet or
exceed this amount.
A purpose of the final rule is to simplify and unify the existing
labeling standards. Labeling standards are currently found in multiple
sections of the regulations and these amendments would move these
standards to one section of the regulations. Through our
[[Page 15]]
revising, consolidating, and redesignating these regulations, parties
wishing to understand the labeling requirements will be able to refer
to a single source. This final rule also includes provisions that add
flexibility to the regulations that should lower the cost of
compliance.
In the proposed rule, we asserted that the new labeling
requirements were consistent with current industry practice and did not
impose an additional burden. We received comments stating that the
proposed labeling requirements for including all communicable disease
test results and a unique facility identifier on the product label did
not conform to current industry practice for certain blood and blood
components intended for further manufacture. In the final rule, as a
result of these comments, we revised these requirements. We have also
amended Sec. 606.121(e)(2)(i) to require that certain red blood cell
product labels must include the type of additive solution with which
the product was prepared. We believe that the labeling requirements of
the final rule conform to current industry practice.
The final rule requires a change in the circular of information to
reflect current testing practices. Existing labeling regulations do not
allow the circular to reflect current required testing or to adjust to
future changes in required testing or plasma thawing procedures. We
believe the circular of information would already be in compliance with
the final rule amendments and reflect current requirements and
practices if compliance were permitted by existing regulations. As the
circular is updated regularly, we believe any required changes can be
made in the ordinary revision cycle at a cost too small to reliably
quantify.
Overall, because the requirements of this final rule are either
industry practice or would be industry practice absent existing
prohibitions, estimated costs are negligible. We believe this action to
be beneficial as it increases flexibility and lowers compliance costs.
Because we believe costs to any entity will be too small to reliably
quantify, we certify that this final rule will not have a significant
impact on a substantial number of small entities.
VI. Environmental Impact
The Agency has determined under 21 CFR 25.30(h) that this action is
of a type that does not individually or cumulatively have a significant
effect on the human environment. Therefore, neither an environmental
assessment nor an environmental impact statement is required.
VII. Federalism
FDA has analyzed this final rule in accordance with the principles
set forth in Executive Order 13132. FDA has determined that the final
rule does not contain policies that have substantial direct effect on
the States, on the relationship between the National Government and the
States, or on the distribution of power and responsibilities among the
various levels of government. Accordingly, FDA has concluded that the
final rule does not contain policies that have federalism implications
as defined in the Executive order and, consequently, a federalism
summary impact statement is not required.
VIII. The Paperwork Reduction Act of 1995
This final rule contains information collection provisions that are
subject to review by the Office of Management and Budget (OMB) under
the Paperwork Reduction Act of 1995 (44 U.S.C. 3501-3520). The title,
description, and respondent description of the information collection
provisions are shown in this section VIII with a discussion of the
information collection burden.
Title: Revisions to Labeling Requirements for Blood and Blood
Components, Including Source Plasma.
Description: FDA is consolidating the regulations related to
labeling blood and blood components. Regulations for labeling of all
blood and blood components would be consolidated in Sec. Sec. 606.121
(Container label) and 606.122 (Circular of information).
Description of Respondents: Manufacturers of blood and blood
components, and blood derivatives.
Burden Estimate: Section 606.121(c)(11) requires that if the
product is intended for further manufacturing use, a statement listing
the results of all the tests for communicable disease agents required
under Sec. 610.40 for which the donation has been tested and found
negative must be on the container label; except that the label for
Source Plasma is not required to list the negative results of
serological syphilis testing under Sec. Sec. 610.40(i) and 640.65(b).
The Agency believes that as a part of industry's usual and customary
labeling business practices, industry currently labels blood and blood
components for further manufacture with the results of required testing
found in Sec. 610.40. In addition, Sec. 606.121(e)(2)(i) requires
that certain red blood cell product labels must include the type of
additive solution with which the product was prepared. The Agency
believes that this labeling requirement of the final rule also is part
of usual and customary industry practice.
Because the Agency believes the rule amendments and the information
collection provisions under Sec. 606.121(c)(11) and (e)(2)(i) in the
final rule are part of usual and customary business practice and do not
create any new burden for respondents, FDA is not estimating the burden
associated with the information collection provisions in this final
rule.
The collection of information requirements under Sec. Sec. 606.121
and 606.122 are approved under OMB control number 0910-0116; in Sec.
640.70 have been approved under OMB control number 0910-0338.
To comply with section 3506(c)(2)(A) of the PRA (44 U.S.C.
3506(c)(2)(A)), elsewhere in this Federal Register, FDA is publishing a
notice of the proposed collection of information set forth in this
document. The collection of information provisions of this final rule
have been submitted to OMB for review. Prior to the effective date of
this final rule, FDA will publish a notice in the Federal Register
announcing OMB's decision to approve, modify, or disapprove the new
collection of information provisions in this final rule. An Agency may
not conduct or sponsor, and a person is not required to respond to, a
collection of information unless it displays a currently valid OMB
control number.
IX. References
The following references have been placed on display in the
Division of Dockets Management (HFA-305), Food and Drug Administration,
5630 Fishers Lane, Rm. 1061, Rockville, MD 20852, and may be seen by
interested persons between 9 a.m. and 4 p.m., Monday through Friday.
FDA has verified the Web site addresses in this document, but FDA is
not responsible for subsequent changes after this document publishes in
the Federal Register.
1. ``Guideline for the Uniform Labeling of Blood and Blood
Components,'' August 1985, https://www.fda.gov/downloads/BiologicsBloodVaccines/GuidanceComplianceRegulatoryInformation/Guidances/Blood/UCM080974.pdf.
2. ``United States Industry Consensus Standard for the Uniform
Labeling of Blood and Blood Components Using ISBT 128,'' November
2005, https://www.fda.gov/downloads/BiologicsBloodVaccines/GuidanceComplianceRegulatoryInformation/Guidances/Blood/UCM079159.pdf.
3. ``Guidance for Industry: Recognition and Use of a Standard for
Uniform Blood and
[[Page 16]]
Blood Component Container Labels,'' September 2006, https://www.fda.gov/downloads/BiologicsBloodVaccines/GuidanceComplianceRegulatoryInformation/Guidances/Blood/ucm079004.pdf.
List of Subjects
21 CFR Part 606
Blood, Labeling, Laboratories, Reporting and recordkeeping
requirements.
21 CFR Part 610
Biologics, Labeling, Reporting and recordkeeping requirements.
21 CFR Part 640
Blood, Labeling, Reporting and recordkeeping requirements.
Therefore, under the Federal Food, Drug, and Cosmetic Act, and the
Public Health Service Act, and under authority delegated to the
Commissioner of Food and Drugs, 21 CFR parts 606, 610, and 640 are
amended as follows:
PART 606--CURRENT GOOD MANUFACTURING PRACTICE FOR BLOOD AND BLOOD
COMPONENTS
0
1. The authority citation for 21 CFR part 606 continues to read as
follows:
Authority: 21 U.S.C. 321, 331, 351, 352, 355, 360, 360j, 371,
374; 42 U.S.C. 216, 262, 263a, 264.
0
2. Revise the heading for subpart G to read as follows:
Subpart G--Additional Labeling Standards for Blood and Blood
Components
0
3. Section 606.121 is revised to read as follows:
Sec. 606.121 Container label.
(a) The container label requirements are designed to facilitate the
use of a uniform container label for blood and blood components
intended for use in transfusion or further manufacture by all blood
establishments.
(b) The label provided by the collecting facility and the initial
processing facility must not be removed, altered, or obscured, except
that the label may be altered to indicate the proper name of the
product, with any appropriate modifiers and attributes, and other
information required to identify accurately the contents of a container
after blood components considered finished prod