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  1. Warning Letters

WARNING LETTER

NuCare Pharmaceuticals Inc MARCS-CMS 588096 —


Delivery Method:
VIA UNITED PARCEL SERVICE
Product:
Drugs

Recipient:
Recipient Name
Jasmine Contreras
NuCare Pharmaceuticals Inc

622 W Katella Ave
Orange, CA 92867
United States

Issuing Office:
Center for Drug Evaluation and Research

10903 New Hampshire Avenue
Silver Spring, MD 20993
United States


WARNING LETTER

 

 

 

 

September 26, 2019

 

 

 WL #1280

 

 

Dear Jasmine Contreras:

 

 

The United States Food and Drug Administration (FDA) has manually reviewed over 200 of your firm’s listing files from August 2017 to the present and has identified many instances where the listing information failed to comply with the applicable requirements. You have failed to address many of the listing deficiencies detailed in multiple deficiency letters addressed to your company dated August 10, 2017, August 14, 2017, and May 14, 2018. Forty-five days after these FDA letters were sent, emails of data removal notifications were sent to your company and at that time, the listing data associated with these deficiencies were removed from the on-line NDC Directory.  Prompt action must be taken to correct the remaining deficiencies.

 

Section 510 of the Federal Food, Drug, and Cosmetic Act (“FD&C Act” or the “Act”) outlines the requirements for registration and listing of drug products. Under section 510 of the Act, and 21 CFR Part 207, with some limited exceptions, firms that manufacture[1] drugs in the United States or that are offered for import into the United States must be registered with the FDA.[2] Every person who is required to register must, at the time of initial registration, list all drugs that are manufactured for commercial distribution.[3] Drug listing information also must be updated in June and December of each year.[4] Drug listing updates must include listing information for each drug manufactured for commercial distribution not previously listed with FDA, information regarding drugs for which manufacturing for commercial distribution has been discontinued and any material changes to previously submitted drug listing information.

 

Although your firm has made some corrections in response to FDA’s deficiency letters, NuCare continues to be in non-compliance with its listing obligations under section 510(j) of the FD&C Act (specifically 510(j)(2) of the Act and various provisions of 21 CFR Part 207. Continued analysis of your firm’s current drug listing files confirms that since FDA first contacted NuCare in August 2017, some of the incorrect listings outlined in the above-mentioned deficiency letters have been addressed and corrected, but many incorrect listings remain unresolved. Also, several drug listings submitted recently by your firm do not meet the listing requirements and include erroneous data.

 

The chart below details examples of existing violations included in deficiency letters, as well as examples of errors found in more recent drug listing submissions.

 

 

Drug Name

NDC

Violation

Date of most recent incorrect submission

 

Permethrin

68071-3294

Incorrect carton label image: the carton label is of Rosuvastatin Calcium while the listed drug is Permethrin (deficiency letter sent on Aug. 14, 2017)

 

March 22, 2019

Fluconazole

68071-4002

Mismatched strength in carton label and listing SPL: the carton label strength is 150 mg while the SPL is 50 mg (deficiency letter sent on Aug. 10, 2017)

 

 

March 19, 2019

Dr. Sheffield Muscle Rub Cream

 

68071-1624

Missing active ingredient names and strengths on the carton label: Menthol 10% and Methyl Salicylate 15% (deficiency letter sent on May 14, 2018)

 

March 7, 2019

Nystatin Cream

 

66267-952

Strength of active ingredient, Nystatin, missing from carton label (deficiency letter sent on May 14, 2018)

 

August 24, 2017

Magnesium Citrate

 

68071-4060

Strength of active ingredient, Magnesium Citrate, 1.745 gm in 29.6 mL is missing from carton label

 

August 18, 2017

Magnesium Citrate

68071-4128

Strength of active ingredient, Magnesium citrate, 1.745 gm in 29.6 mL is missing from the carton label

 

October 25, 2017

Bisoprolol Fumarate

68071-1582

Incorrect carton label: the carton label is an image of Gemfibrozil while the listed drug is Bisoprolol fumarate

 

March 15, 2019

Carisoprodol

68071-4263

DEA Schedule of this Schedule IV controlled substance is not listed in the SPL

 

Feb. 2, 2018

Doxycycline

68071-4883

Incorrect carton label:

the carton label includes an image of Montelukast Sodium 5 mg, while the listed drug is Doxycycline hyclate

 

May 3, 2019

Ear Wax Removal Drops

66267-976

Incorrect carton label: the carton label image is of Hydrocortisone cream, while the listed drug is Ear Wax Removal Drops

 

May 6, 2019

Losartan Potassium

68071-4943

Incorrect carton label: the carton label is an image of Amoxicillin, while the listed drug is Losartan Potassium

June 25, 2019

 

Your firm failed to fulfill its listing obligations under Section 510(j) of the FD&C Act, which is a prohibited act under section 301(p) (21 U.S.C. 360[j] and 331[p]). In addition, your firm’s failure to fulfill its listing obligations misbrands the product under section 502(o) of the FD&C Act.  Introduction or delivery for introduction into interstate commerce of a misbranded product is a prohibited act under section 301(a) (21 U.S.C. 352[o] and 331[a]).

 

Within seven working days of receipt of this letter please notify this office, in writing, of the specific steps you have and will take to promptly identify and correct each violation, to bring all your products into compliance. Your response also should include an explanation of the specific steps you have and will take to prevent the recurrence of violations. For any steps not completed before submitting this notice, please provide the dates when such steps will be completed.

 

Your response should include enough information to allow us to evaluate whether the steps you have and will take are enough to correct each violation and prevent the recurrence of violations.  Such responses typically would include, at a minimum, a discussion of:

  • How your firm reviewed, or plans to review, all current drug listings to identify those listings that need to be updated;
  • How your firm corrected, or plans to correct, the identified errors (e.g., submit corrected SPL files for existing listings, delist NDCs no longer in use by submitting end marketing dates and changing marketing status to complete); and
  • The plan or process your firm has implemented, or plans to implement, to prevent the recurrence of the violations.

 

Your reply should be sent to:

 

Tasneem Hussain, Pharm. D.

eDRLS Staff

Food and Drug Administration

10903 New Hampshire Avenue

Building 51, Room 2261

Silver Spring, MD 20993-0002

 

Please be aware that a manual override may be required for certain types of revisions made to an existing drug listing file. If you receive a validation error or have any questions regarding the contents of this letter, please contact us at edrls@fda.hhs.gov for further assistance. Include the case identification number of 1280 on all correspondence.

 

Finally, you should know that this letter is not intended to be an all-inclusive list of the violations of your firm’s registration and product listing obligations or other obligations. It is your firm’s responsibility to ensure compliance with all applicable laws and regulations administered by FDA.

 

 

                                                                                  

Sincerely,

/S/

Maria Rossana R Cook

 

cc:       drugs@registrarcorp.com

 

cc:       Los Angeles District Office

 

Attn:   FDA Correspondence

 

 

[1] The term “manufacture” includes each step in the manufacture, preparation, propagation, compounding, or processing of a drug, including relabeling, repackaging, and salvaging activities. 21 CFR. 207.1. 

[2] FD&C Act § 510(b), (c), (d), & (i) (21 U.S.C. § 360(b), (c), (d), & (i)).

[3] FD&C Act § 510(j)(1) (21 U.S.C. § 360(j)(1)); see also 21 C.F.R. 207.41.

[4] FD&C Act § 510(j)(2) (21 U.S.C. § 360(j)(2)); see also 21 C.F.R. 207.57.