While performing a facility survey, unit survey, or equipment evaluation, the medical physicist determines that the unit fails a required test(s) and needs to be adjusted, changed, or repaired. After the adjustment, change, or repair has been completed, does the test(s) have to be repeated and must the medical physicist perform the test(s)?

After the adjustment, change, or repair has been completed, the test(s) have to be repeated and must show that the unit is within the appropriate action limit (verification test). For failures of the tests described in 900.12(e)(8)(ii)(A), 900.12(e)(6), 900.12(e)(7) and/or after adjustments, changes, or repairs that are classified as major, the verification test must be passed prior to using the item clinically. Note: verification testing performed after a major repair must be performed on-site by the medical physicist as required by 900.12(e)(10).

For failures of the tests described in 900.12(e)(8)(ii)(B), the facility has a maximum of 30 days from the date of the initial test failure to correct the problem and pass the verification test. Facilities should have the verification test(s) performed (either by the medical physicist or by a qualified individual) as soon as possible after the adjustment, change, or repair is done, so as to allow time to repeat the adjustment, change, or repair if the equipment does not pass the verification test. Note: if the verification test is not passed within the 30 day time period, the item cannot be used clinically until such time as it is truly repaired and passes the test.

For non-major equipment adjustments, changes, or repairs that are performed for any reason other than for failure of a required test, the facility must correct any problems found and perform verification tests to ensure that the equipment remains in compliance with the regulations. This should be accomplished as soon as reasonably possible.

If the adjustment, change, or repair constitutes a "major repair (see Medical Physicist Involvement in Equipment Adjustments, Changes, or Repairs table below)," the medical physicist must repeat the test(s) as part of the required follow-up equipment evaluation. If the adjustment, change, or repair does not constitute a "major repair," the test(s) can be performed by any qualified person (e.g. radiologic technologist or service representative with appropriate training/experience). However, in this circumstance, FDA recommends that the medical physicist be consulted during this process.

The following decision trees may be used to help in determining the timing and extent of physicist and facility involvement in response to test failures, equipment adjustments/changes/repairs and equipment evaluations.

Decision Tree #1. Failure of a test(s) described in 900.12(e)(8)(ii)(A): Use of test results, 900.12(e)(6): Quality control tests -- other modalities, 900.12(e)(7): Mobile units.

Decision Tree #2. Failure of a test(s) described in 900.12(e)(8)(ii)(B): Use of test results.

*Note: In some cases, failures of the test(s) described in 900.12(e)(8)(ii)(B) and non-major adjustments, changes, or repairs may necessitate a verification test(s) described in 900.12(e)(8)(ii)(A). In those cases where an item fails its 900.12(e)(8)(ii)(A) verification test(s), the item cannot be used until such time as the verification test is passed.

Decision Tree #3. Non-major equipment adjustment, change, or repair for any reason other than failure of a required test.

Decision Tree #4. Equipment evaluations (new equipment, reassembly, or major adjustments, changes, or repairs).