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U.S. Department of Health and Human Services

Inspections, Compliance, Enforcement, and Criminal Investigations

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Marlette Community Hospital 22-Feb-02


Food and Drug Administration

Detroit District

1560 East Jefferson Avenue

Detroit, MI 48207-3179

Telephone: 313-226-6260





February 22, 2002

Lionel Gorbaty, M.D.

Mammography Supervisor

Marlette Community Hospital

2770 Main Street

Marlette, MI 48453

Dear Dr. Gorbaty:

We are writing you because on February 20, 2002, your facility was inspected

by a representative of the State of Michigan acting in behalf of the Food & Drug

Administration (FDA). The inspection revealed a serious regulatory problem

involving the mammography at your facility.

Under a United States Federal law, the Mammography Quality Standards Act of

1992 (MQSA), your facility must meet specific requirements for mammography.

These requirements help protect the health of women by assuring that a facility

can perform quality mammography.

The inspection revealed the following Repeat Level 2 finding at your facility:

Your mammography technologist, [redacted] did not have sufficient continuing

education credits to meet the requirement of 15 CEU?s within the previous 36

month period. Documentation available at the time of the inspection totaled 9.5


The specific problem noted above appeared on your MQSA Facility Inspection

Report (copy enclosed), which your facility received at the close of the

inspection. This problem is identified as a Repeat Level 2 because it identifies

a failure by your facility to implement permanent correction of the same problem

found during your previous inspection.

Because this condition may be symptomatic of serious underlying problems that

could compromise the quality of mammography at your facility, it represents a

violation of law which may result in FDA taking regulatory action without further

notice to you. These actions include, but are not limited to placing your facility

under a Directed Plan of Correction, charging your facility for the cost of onsite

monitoring, assessing civil money penalties up to $10,000 for each failure to

substantially comply with MQSA standards, suspension or revocation of your

facility? s FDA certificate, or obtaining a court injunction against further


It is necessary for you to act on this matter immediately. Please explain to this

office in writing within fifteen (15) working days from the date you receive this


  • the specific steps you have taken to correct the Repeat Level 2 violation noted in this letter;
  • each step your facility is taking to prevent the recurrence of similar violations;

Please submit your response to: Mr. David M. Kaszubski

Director Compliance Branch

U. S. Food & Drug Administration

1560 East Jefferson Ave.

Detroit, MI 48207-3179

Please note that FDA regulations do not preclude a State from enforcing its own

State mammography laws and regulations. In some cases, these requirements

may be more stringent than FDA?s When you plan your corrective actions, you

should consider the more stringent State requirements, if any. You should also

send a copy to the State of Michigan radiation control office that conducted the

inspection referenced in this letter. You may choose to address both the FDA

and any additional State requirements in your response.

Finally, you should understand that there are many FDA requirements pertaining

to mammography. This letter only pertains to findings of your inspection and

does not necessarily address other obligations you have under law. You may

obtain general information about all of FDA?s requirements for mammography

facilities by contacting the Mammography Quality Assurance Program, Food and

Drug Administration, P.O. Box 6057, Columbia, MD 21045-6057 (1-800-838-

7715) or through the Internet at http://www.fda.gov/cdrh/mammography.

If you have more specific questions about mammography facility requirements or

about the content of this letter, please feel free to contact Mr. Dennis E. Swartz,

Radiological Health Expert, at 313-226-6260 Ext.155.


Joann Givens

District Director

Detroit District