- 0 9 / 16/2015*

1431 Harbor Ba y Parkway

Alameda, CA 94 5 02- 707 0
(510) 337-6700 Fax:( 5 1 0 ) 337-6702
Industry Information: ~~w . fda .gov/ oc /industr
TO:

Ramesh (NMI ) Balwanl, Pre sident and

rations Officer

~-=~~
a~.~~,~.~~~~~~~~~---------

Theranos , I n c.
CIIY,8TATE.Zli'OO

30062 3 1 732

Newark, CA

7333 Gate wa y Bl vd .

rrRY

94560

Medical Devi ce Manufacturer

This document Hsts observations made by the FDArepresentative(a) dwing the iuspection ofyour .filoility. They are inspectional
observations. and do not rcp"*'lt a final Agencydetcrmlnation regarding your compliance. Ifyou have an objection regarding an
observation, or have implemented, or plim to implement., col%00tive a<-'tion in respoose to an observation, you may discuss the objecti.on or
action with the FDA representative(s) during the inspection or submit this information to FDA at the addzess above. Ifyou have any
questions, please contact FDA at the phone number and address above.

The observations noted in this Form FDA-483 are not an exhaustive ?Wing of objectionable conditions. Under the law, your
.f11711 is responsible for condvcting inlenwl !U!lf-audits to idmttify and comu:t any and a1J violations ofthe qu~ity system
requirements.
DURING AH I.HSPECTlON OFYOlR FIRM WE OBSERVED:

OBSERVATION 1
Devices for which listing is required have not been listed.
as such

as a

and you are C'UlTeutl.y

i.dent:ifYingit as a Class I eXempt medic8I dcvU:c. Yo)l are cmrent1y shipping this unclearod medical device in intersmw
commerce. between California, Arirona, and Pennsylvania.
OBSERVATION 2
Procedures for receiving. reviewing, and evaluating complaints by a formally designated unit have not been adequately
es1ablished.

'Specifically, your two~

Customec Complaiots, Doc:uJlJieD Number SOP-00174, Rmsion A, Effecti.ve

Dille 07102/2014", and
NumberCS SOP..05071, RmsionA, Eft'ectivei>atc 03127/2015" do bot
acc:urately describe 1he e complaint handling procedw-e that you carrartly employ to receive, review, and evaluate
(;UIItomer complaints. The procedure that you vCI'bally described, during tbe Cl.lm.mt inspection is as follows:

SEE REVERSE
OF THIS PAGE
IOJIIUDA 4&3

3006231732

Device Manufacturer

Your Written procedures do not describe your complaint handling as you verbally described~ inspection. The
'Iberanos QA complaint log that you provided contained no logged complaints; however. th~mplaint Jog that
you also subsequently provided contained CTN-related complaints.
OBSERVAnON 3
Complaint3 involving the possible failure ofa device to meet any of its specifications were not revieWed. evaluated, and
investigated where necessai)'.

Specifically, a comPlaint that was reported to you via NCR-01926 on 01/3012015 was not handled as a complaint in
compliance with yolD' written procedure "Customer CoJIIlPI.aiDlts,

07/0212014". NCR-01926 was areportofacomplaintfrom

were "difficulties in inspecting ern specimen qualiey.R.e:porm''llllerti

were too opaque to be able
to see clotting clearly". You did not ide:ntify this as a complaint and you did not investigate it ~ a complaiot, nor did you
investigam ifibis complamt rcquinld the filiog ofMDRs. 'lb:ia.complaini was not dMIIMided in your complain~ log.
OBSERVATION 4

COtTective and preventive action. activities 8Ddlor ~suits bave not been documented
Specifically, you undertook several cor:rections ofyoilr Quality Management System procedures and records wid:tout
documenting the investigations ofcauses ofthe nonconfonnities, 1he actions needed to cmrect or prevent recurrence of
similar quality problems, the verification or validation of com:ctive actions, and the dissemination ofinfurmation about the
quality problems to responsible parties. DuriDg this inspection you cindertook to comet procedures and records for your

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OF THIS PAGE

Mary R. Hole, Investigator

Yung W. Chan, I nvestigator
Stay c e E. Beck, I n vestigator

------------""'\PUAiinn:NTOFID'ALTBAND~S.ER\IIQS

____ _ _ __,,__.._.,..

FOOD AND DR.l10 ADMlNISmAT!ON

DIS

1431

- 09/16/2015*
337 - 6'( 02

TO:

3006231 732

Ramesh (NMI) Balwani , Presi dent

Theranos , Inc.
aTY, STA

Ne wark , CA

TYPEESTAI!IJ8HIIENT

Medica l Device Manufacture r

94560

Complaint Handling. supplier qualifications, DHRB, and intmnal audits without opening CAPAs to document your
investigation into the causes ofthese deficieocies and their impact on your Quality Management System, an analysis and plan
of what coJTCCt:ions were required, whether the corrections impacted other areas of your Quality Maoagement System. and the
dissemination ofthe informatim about these issues to your firm's employees.
Foi example. during this inspection you were tmable to produce documented supplier qualifications, a you corrected the
deficiency by assembling tbc required supplier qualification documents for your suppliers. You did this without opening a
CAPA that investigated the probable cause for not having supplier qruilffication documentation, or ta investigate iftbese
suppliers bad met your quality requirements the entire time in the past when you bad purchased materials from them with
which you bad manufacturedyourfm ished products, or ifyour purchasing departmeniJK2'SODilelrequiredtraining to ensure
future compliance with this required quality activity, and trailrlng that may be required by other employe= making purchases
so that they und~staud tbe probable qualit-f impact on products made wida materials sourced from un.approved suppliers.This
correction of your lack of dOCliD.lented supplier qualification was not documented in a CAPA that coutWned an effectivcne!!11
plan to ensure that the correction you undertook would reduce or eliminate any future recm:rence of this situation.
OBSERVATION 5
Software validation activities and results fur computers or automated data processing systems used as part ofproduction an.d
the quality system have not been documented.

being
ttm78JJJIIIIbi)Q Excel sprea&hcet does not document a

the identity of the

QA review oftbe data.

part ofthe Device History File.

...... .

OBSERVATlON 6

The evaluation of potential suppliers was not documented.

ho'\ll~e""~- you did not have documented approved supplier qualifications

suppliers oo your Approved Supplier List until after the start of the current inspection.

approved SDpplier quatifitatio~ the start of this

you use in the JIUIIIIIt&cture of~s from this

SEE REVERSE

OF THIS PAGE

Mary R . Hole , I nvestigator

Yung W. Chan, I nvestigato r
Stay c e E . Be c k , Investi gator

09/16/2015

PAtlll l Cl' 6 PAOiiS

5*

3006231732
President

Medica l Device Manufacturer

N~ yoorsuppliero~ on07116/2015you
this vendor; however, you had no documented approved supplier
09/07/2015.

OBSERVATION 7

Records of acceptable suppliers have not been adequately estab1ished.

ho'lllreVt'il"~ 0D

in the manufacturing of your C'fNs via Purchase Order Nutnt.,...

OBSERVATION 8

Procedures for device histocy m:ords have not been adequately established.

OC'Illmeo.tmg the
the IJl.8JJDfacturi

Lot

numbers
~

~ include copies ofthe primaiy identification label ~was applied to 1he

maJmfiiCtUrrcd with those lot numbers.

OBSERVATION 9

Quality audits have not been performed..

Specifically. you have not monitored your Quality Management System throagb. inte:mal quality andD; you had no
documenred intfmal quality audit schedule to DJDnitor your Quality Management System until after the start ofthis
inspection.
Number SOP-00177, Efl.iecti'lle
07/0212014" states

no internal audits were~~~

PAGI!4 OF

DUAJlTMENI O:P BEALm AND lltJMAN SJ:RVICES

oamtiC1T---

FOOD AND awG .ADMINlSmA110N

CIIT(:10)0F

1431 Harbor Bay Parkway

Al ameda, CA 94502-7070
(510) 337-6700 Fax: (510) 337-6702
lndustry Information: www.fda . gov/oc/industry

-NJmu.OF_,.,..,...TO

TO:

Ramesb

(~~r)

Balwani , President and Chief Operat3ons Officer

00""""'-

Theranos, Inc .

-at

7333 Gateway Blvd.

lYPEEIJT~ -

cm".STA-re.2JI' QXll:. CXIUIIlRY"

CA

SEE REVERSE
OF THIS PAGE

94560

300'6231732

o""""""'

--

Newark,

08/25/2015 - 09/16/2015*
f'll

:;JED

. Medical Device Manufacturer

the start of1his inspection, yourTMP..ooo32~ blank..

Mary R. Hole, Investigator

Yung W. Chan , Investigator
Stayce E. Beck , Investigator

INSI"ECTIONALO~VATI~

PAGn5 01'6l'AGBS

m&TRICT

.....

......,...,.,....,PI<ONE.._H

1431 Harbor Bay Parkway

Alameda, CA 94502- 7070
(510} 337-6700

__

08/25/2015 - 09/16/2015*
~

3006231732

Fax:(510) 337-6702

Industry Information: www.fda.gov/oc/industry

IWIEJIHOTII"..EOF' NliiiDlAL TO\\"""~ I6SUED

-ro :

Ramesh

( NMI)

Ba.J.wani , President and Chief Operations Officer

~~~~~~~~~~~~~~~~~~~----------------------~

Theranos, Inc.

7333 Gateway Blvd .

,.....,,___,.r NIPCTEil

CllY. ST"~ lll' COlE, COUII!RY

Newark, CA

Medica~

94560

Device Manu facturer

Observation A11notatioDs
Observation 1:
Observation 3:
Observation 5:
Observation 7:
Observation 9:

Under consideration.

Observation 2:

Promised to correct within 7 days.

Observation 4:
Observation 6:

Promised 1o correct within 7 days.

Promised to correct within 7 days.
Promised 1o correct within 7 days.

Obscrntion-1:

Promised 10 correct wi1bJn 7 days.

Promised to corrcot within 7 days.

Prom.ised to correct within 7 days.

Promised to correct witbin 7 days.

*DATES OF INSPECTION:

O&J2S/20 1S(Tue). 0812612015{Wed), 08J27/201S(Ihu), 0111.2.812015(Fri}, 09101/2015(1'\lc), 09/0211.015(Wed), 09f0412015(Fr.i),

09Jt)8120J5(1'ue}, 09/10/201S(Thu), 09/16J2015(Wed)

Mary R. Hol e , Investigator

SEE REVERSE
OFTHJSPAGE

01\TE !SlUED

Yung ~ . Chan, Investigator ~----~~==~~~~~~~=>----1!,09 / l 6 /20lS

Stayce E. Beck, Investigator
"--~ ~\ ~~

--

INsncTIONALOBSI!RVATIONS

PAO.B 6 OP 6 PACES